Zeltzer L K, Chen E, Weiss R, Guo M D, Robison L L, Meadows A T, Mills J L, Nicholson H S, Byrne J
Department of Pediatrics, University of California at Los Angeles, USA.
J Clin Oncol. 1997 Feb;15(2):547-56. doi: 10.1200/JCO.1997.15.2.547.
To determine psychologic outcome, with the focus on emotional or mood state, of young adult survivors of childhood acute lymphoblastic leukemia (ALL) compared with sibling controls and to identify vulnerable subgroups at highest risk for negative mood.
Adult survivors (n = 580), aged > or = 18 years, who were treated before age 20 years on Children's Cancer Group (CCG) protocols for ALL and 396 sibling controls were administered a structured telephone interview and the Profile of Moods State (POMS), a standardized measure of affective state.
Survivors had higher total mood scores (which indicates greater negative mood) than sibling controls (P<.01) and reported more tension (P< .01), depression (P<.01), anger (P<.01), and confusion (P<.01), but not more fatigue or less vigor. Female, minority, and unemployed survivors reported the highest total mood disturbance. Overall, survivors were more likely to be unemployed (P<.05) or working less than half-time (P<.01) compared with controls.
This large, sibling-controlled, multisite study of young adult survivors of childhood ALL treated on CCG protocols after 1970 found significant increased negative mood in survivors, not accounted for by reported energy level differences, which suggests that these emotional effects are not likely the result of current illness. Survivors are less likely to be fully employed. Female, minority, and unemployed survivors are at greatest risk for emotional sequelae, a finding that indicates the need for targeted, preventive intervention.
比较儿童急性淋巴细胞白血病（ALL）成年幸存者与同胞对照者的心理结局，重点关注情绪或心境状态，并确定负性情绪风险最高的脆弱亚组。
对1970年后按照儿童癌症组（CCG）方案在20岁前接受ALL治疗的18岁及以上成年幸存者（n = 580）和396名同胞对照者进行了结构化电话访谈，并使用了情绪状态剖面图（POMS），这是一种情感状态的标准化测量方法。
幸存者的总情绪得分（表明负性情绪更强）高于同胞对照者（P <.01），且报告有更多的紧张情绪（P <.01）、抑郁情绪（P <.01）、愤怒情绪（P <.01）和困惑情绪（P <.01），但疲劳感并未增加，精力也未减少。女性、少数族裔和失业的幸存者报告的总情绪困扰最高。总体而言，与对照者相比，幸存者更有可能失业（P <.05）或工作时间不足半职（P <.01）。
这项针对1970年后按照CCG方案接受治疗的儿童ALL成年幸存者进行的大规模、同胞对照、多中心研究发现，幸存者的负性情绪显著增加，这并非由报告的能量水平差异所致，这表明这些情绪影响不太可能是当前疾病的结果。幸存者完全就业的可能性较小。女性、少数族裔和失业的幸存者出现情绪后遗症的风险最大，这一发现表明需要进行有针对性的预防性干预。
