A French cohort of childhood leukemia survivors: impact of hematopoietic stem cell transplantation on health status and quality of life

Biol Blood Marrow Transplant. 2013 Jul;19(7):1065-72. doi: 10.1016/j.bbmt.2013.04.015. Epub 2013 Apr 22.

Abstract

The late effects and quality of life (QoL) in childhood acute leukemia survivors were compared between hematopoietic stem cell transplantation (HSCT) recipients and patients who underwent conventional therapy. The study included 943 patients, 256 of whom underwent HSCT (27.1%). Medical visits were conducted to detect the occurrence of physical late effects. Based on patient age, different questionnaires were used to assess QoL. To evaluate the association between HSCT and each type of late effect or QoL dimension, the appropriate multivariate regressions were performed. QoL mean scores were compared with those obtained for age- and sex-matched French control subjects. Of all the survivors, 674 (71.5%) had at least 1 late effect, with the risk being 5.0 CI95 (3.0-8.6) times higher for transplantation survivors. For child survivors, scoring of QoL showed no significant differences between the treatment groups. The adult HSCT survivors reported lower physical dimension QoL scores than chemotherapy survivors. Compared with French norms, the survivor group reported a significantly lower mental composite score; however, the physical composite score showed no significant difference. Thus, transplanted survivors have a high risk of developing late effects, resulting in a decreased physical well-being in adulthood. However, long after treatment completion, childhood leukemia survivors report that effects on psychological well-being are more important than they are in physical QoL dimensions.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Antineoplastic Agents / therapeutic use
  • Child
  • Female
  • France
  • Hematopoietic Stem Cell Transplantation*
  • Humans
  • Male
  • Multivariate Analysis
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / pathology
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / psychology*
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / therapy
  • Quality of Life
  • Research Design
  • Retrospective Studies
  • Surveys and Questionnaires
  • Survivors / psychology*
  • Transplantation, Homologous

Substances

  • Antineoplastic Agents