School of Nursing, University of Minnesota, Minneapolis, MN, USA.
Cancer and Blood Disorders Program, Children's Minnesota, Minneapolis, MN, USA.
J Pediatr Hematol Oncol Nurs. 2023 Nov-Dec;40(6):386-399. doi: 10.1177/27527530221148479. Epub 2023 Apr 12.
Symptoms in children with acute lymphocytic leukemia (ALL) change over the trajectory of treatment but little is known about their symptoms as treatment ends. Physical activity may help decrease symptom distress and is vital for ongoing development. The role of biomarkers in symptom science is emerging. The purpose of the study was to explore relationships between self-report of symptoms and physical activity, actigraphy measures, and cerebrospinal fluid (CSF) biomarkers. Participants were children who were ages 3 to 18 years at the time of ALL diagnosis and were now in the last 12-week cycle of ALL maintenance. Self-reports of fatigue, sleep disturbance, depressive symptoms, and physical activity were completed by participants and parents of younger children. Participants wore a wrist actigraph continuously for the 7 days before other measurements. F2-isoprostanes and interleukin-8 were evaluated in CSF samples. Among the 15 participants, self-report of symptoms and physical activity indicated levels similar to healthy peers. F2-isoprostane had a strong positive correlation with fatigue levels and with depressive symptoms. Fatigue, sleep disturbance, and depressive symptoms positively correlated with each other. Actigraph measures showed children met the CDC guidelines for 60 min of daily moderate to vigorous activity; sleep time was slightly less than healthy norms. During maintenance therapy, most children return to healthy norms in symptom burden and physical activity. F2-isoprostane in the CSF is a biomarker for fatigue and depressive symptoms. Children who had persistent symptoms experienced them as a cluster, which confirms previous symptom cluster research.
急性淋巴细胞白血病（ALL）患儿的症状在治疗过程中会发生变化，但对于治疗结束时的症状知之甚少。身体活动可能有助于减轻症状困扰，对持续发展至关重要。生物标志物在症状科学中的作用正在显现。本研究的目的是探讨症状自评与身体活动、活动记录仪测量值和脑脊液（CSF）生物标志物之间的关系。参与者为 ALL 确诊时年龄在 3 至 18 岁的儿童，目前处于 ALL 维持治疗的最后 12 周周期。疲劳、睡眠障碍、抑郁症状和身体活动的自评由参与者及其年龄较小的儿童的父母完成。参与者在其他测量前连续佩戴腕部活动记录仪 7 天。CSF 样本中评估了 F2-异前列腺素和白细胞介素-8。在 15 名参与者中，症状自评和身体活动表明其水平与健康同龄人相似。F2-异前列腺素与疲劳水平和抑郁症状呈强正相关。疲劳、睡眠障碍和抑郁症状相互之间呈正相关。活动记录仪测量值显示，儿童符合 CDC 指南中每天进行 60 分钟中等至剧烈身体活动的建议；睡眠时间略低于健康标准。在维持治疗期间，大多数儿童的症状负担和身体活动恢复到健康水平。CSF 中的 F2-异前列腺素是疲劳和抑郁症状的生物标志物。持续存在症状的儿童会将其作为一个症状群经历，这证实了先前的症状群研究。
