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造血干细胞移植对白血病和地中海贫血患儿生活质量及行为结果的影响

Impacts of Hematopoietic Stem Cell Transplantation on Quality of Life and Behavioral Outcomes in Pediatric Patients with Leukemia and Thalassemia.

作者信息

Kara Uzun Aysun, Akkuş Sevilay Yıldız, Koca Yozgat Ayça, Yüksel Fadime, Arman Bilir Özlem, Yaralı Hüsniye Neşe, Özbek Namık Yaşar

机构信息

Department of Pediatrics, University of Health Sciences, Ankara 06018, Turkey.

Division of Social Pediatrics, Department of Pediatrics, Children's Hospital, Ankara Bilkent City Hospital, Ankara 06800, Turkey.

出版信息

Curr Oncol. 2025 May 28;32(6):311. doi: 10.3390/curroncol32060311.

Abstract

BACKGROUND

This study aimed to investigate the effects of allogeneic hematopoietic stem cell transplantation (HSCT) on quality of life and behavioral problems in children diagnosed with leukemia and β-thalassemia major, with a focus on post-transplant diagnosis-specific differences in psychosocial adjustment.

METHOD

This study included 112 children (63 children with acute leukemia, 49 children with β-thalassemia major) aged 6-18 years, along with a control group of 30 healthy children within the same age range. The Pediatric Quality of Life Inventory (PedsQL) and the Child Behavior Checklist for Ages 6-18 (CBCL) were administered. Participants were categorized into five groups, and the outcomes were compared accordingly.

RESULTS

The emotional functioning subscale scores of the PedsQL were significantly lower in children with leukemia and those who had undergone HSCT for leukemia, when compared to children with thalassemia ( < 0.05). The social functioning subscale scores were also significantly lower in children with leukemia who underwent HSCT compared to those with thalassemia ( < 0.05). The CBCL internalizing scores were higher in children with leukemia and post-HSCT leukemia patients than in their healthy peers ( < 0.05). Over time, both diagnostic groups showed improvements, with total PedsQL scores increasing and total CBCL scores decreasing after HSCT.

CONCLUSIONS

This study demonstrates that quality of life improved and behavioral problems diminished over time following HSCT. However, the psychosocial impact of HSCT varied depending on the underlying disease, with children diagnosed with leukemia being slightly more adversely affected. These findings suggest that interventions aimed at improving quality of life and addressing behavioral issues should be tailored to the specific diagnosis.

摘要

背景

本研究旨在调查异基因造血干细胞移植(HSCT)对诊断为白血病和重型β地中海贫血的儿童生活质量和行为问题的影响,重点关注移植后心理社会适应方面特定诊断的差异。

方法

本研究纳入了112名6至18岁的儿童(63名急性白血病儿童,49名重型β地中海贫血儿童),以及一个由30名同年龄范围的健康儿童组成的对照组。采用了儿童生活质量量表(PedsQL)和6至18岁儿童行为清单(CBCL)。参与者被分为五组,并据此比较结果。

结果

与地中海贫血儿童相比,白血病儿童及接受HSCT治疗的白血病儿童的PedsQL情感功能子量表得分显著更低(<0.05)。与地中海贫血儿童相比,接受HSCT治疗的白血病儿童的社会功能子量表得分也显著更低(<0.05)。白血病儿童及HSCT后白血病患者的CBCL内化得分高于其健康同龄人(<0.05)。随着时间推移,两个诊断组均有改善,HSCT后PedsQL总分增加,CBCL总分降低。

结论

本研究表明,HSCT后随着时间推移生活质量得到改善,行为问题减少。然而,HSCT的心理社会影响因潜在疾病而异,诊断为白血病的儿童受到的负面影响略大。这些发现表明,旨在改善生活质量和解决行为问题的干预措施应根据具体诊断进行调整。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4dc8/12191752/b1246a0d5c57/curroncol-32-00311-g001.jpg

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