Children's National Health System, Washington, District of Columbia, USA.
Clemson University School of Nursing, Clemson, South Carolina, USA.
Pediatr Blood Cancer. 2022 Dec;69(12):e29986. doi: 10.1002/pbc.29986. Epub 2022 Sep 24.
Leukemia and lymphoma (LL) are the most common cancer diagnoses of childhood with high survival rates, but not without impact on the child's functioning and quality of life. This study aimed to use patient-reported data to describe the symptomatic adverse event (AE) experiences among children with LL diagnoses.
Two hundred and fifty seven children and adolescents aged 7-18 years with a first LL diagnosis completed the Pediatric Patient-Reported version of the Common Terminology Criteria for Adverse Events (Ped-PRO-CTCAE) and Patient-Reported Outcome Measurement Information System (PROMIS) Pediatric measures before starting a treatment course (T1) and after the treatment (T2).
Fatigue was the most severe AE (68.1% at T1; 67% at T2) and caused the most interference over time. Gastrointestinal AEs were also quite common (e.g., nausea 46.3% at T1 and 48.9% at T2; abdominal pain 42.4% at T1; 46.5% at T2). In general, symptoms were present both at T1 and T2 and did not change significantly in severity or interference. The prevalence of AEs varied by LL disease group (e.g., nausea was most common in acute lymphoblastic leukemia (ALL), fatigue was most severe in ALL and Hodgkin Lymphoma (HL), acute myeloid leukemia had the fewest AEs).
Despite current supportive care regimens, many children with LL continue to report fatigue, pain, insomnia, and gastrointestinal symptoms as the most frequent or severe symptoms during therapy.
白血病和淋巴瘤(LL)是儿童中最常见的癌症诊断,存活率高,但对儿童的功能和生活质量仍有影响。本研究旨在使用患者报告数据描述初诊 LL 儿童的症状性不良事件(AE)体验。
257 名 7-18 岁的儿童和青少年在开始治疗疗程(T1)前和治疗后(T2)完成了《儿科患者报告通用术语标准不良事件》(Ped-PRO-CTCAE)和《患者报告结局测量信息系统》(PROMIS)儿科量表的儿科患者报告版本。
疲劳是最严重的 AE(T1 时为 68.1%;T2 时为 67%),且随着时间的推移干扰最大。胃肠道 AE 也很常见(例如,T1 时恶心发生率为 46.3%,T2 时为 48.9%;T1 时腹痛发生率为 42.4%;T2 时为 46.5%)。一般来说,T1 和 T2 时均存在症状,且严重程度或干扰程度无明显变化。AE 的患病率因 LL 疾病组而异(例如,恶心在急性淋巴细胞白血病(ALL)中最常见,疲劳在 ALL 和霍奇金淋巴瘤(HL)中最严重,急性髓细胞白血病的 AE 最少)。
尽管目前有支持性护理方案,但许多患有 LL 的儿童在治疗期间仍报告疲劳、疼痛、失眠和胃肠道症状是最常见或最严重的症状。