Prospective longitudinal evaluation of treatment-related toxicity and health-related quality of life during the first year of treatment for pediatric acute lymphoblastic leukemia.

Schilstra, CE; McCleary, K; Fardell, JE; Donoghoe, MW; McCormack, E; Kotecha, RS; Lourenco, RDA; Ramachandran, S; Cockcroft, R; Conyers, R; Cross, S; Dalla-Pozza, L; Downie, P; Revesz, T; Osborn, M; Alvaro, F; Wakefield, CE; Marshall, GM; Mateos, MK; Trahair, TN

Prospective longitudinal evaluation of treatment-related toxicity and health-related quality of life during the first year of treatment for pediatric acute lymphoblastic leukemia.

Schilstra, CE McCleary, K Fardell, JE Donoghoe, MW McCormack, E Kotecha, RS Lourenco, RDA Ramachandran, S Cockcroft, R Conyers, R Cross, S Dalla-Pozza, L Downie, P Revesz, T Osborn, M Alvaro, F Wakefield, CE Marshall, GM Mateos, MK Trahair, TN

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Publisher:: Springer Nature
Publication Type:: Journal Article
Citation:: BMC Cancer, 2022, 22, (1), pp. 985
Issue Date:: 2022-09-15

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Field	Value	Language
dc.contributor.author	Schilstra, CE
dc.contributor.author	McCleary, K
dc.contributor.author	Fardell, JE
dc.contributor.author	Donoghoe, MW
dc.contributor.author	McCormack, E
dc.contributor.author	Kotecha, RS
dc.contributor.author	Lourenco, RDA
dc.contributor.author	Ramachandran, S
dc.contributor.author	Cockcroft, R
dc.contributor.author	Conyers, R
dc.contributor.author	Cross, S
dc.contributor.author	Dalla-Pozza, L
dc.contributor.author	Downie, P
dc.contributor.author	Revesz, T
dc.contributor.author	Osborn, M
dc.contributor.author	Alvaro, F
dc.contributor.author	Wakefield, CE
dc.contributor.author	Marshall, GM
dc.contributor.author	Mateos, MK
dc.contributor.author	Trahair, TN
dc.date.accessioned	2023-04-13T01:28:18Z
dc.date.available	2022-09-09
dc.date.available	2023-04-13T01:28:18Z
dc.date.issued	2022-09-15
dc.identifier.citation	BMC Cancer, 2022, 22, (1), pp. 985
dc.identifier.issn	1471-2407
dc.identifier.issn	1471-2407
dc.identifier.uri	http://hdl.handle.net/10453/169714
dc.description.abstract	BACKGROUND: Pediatric acute lymphoblastic leukemia (ALL) therapy is accompanied by treatment-related toxicities (TRTs) and impaired quality of life. In Australia and New Zealand, children with ALL are treated with either Children's Oncology Group (COG) or international Berlin-Frankfurt-Munster (iBFM) Study Group-based therapy. We conducted a prospective registry study to document symptomatic TRTs (venous thrombosis, neurotoxicity, pancreatitis and bone toxicity), compare TRT outcomes to retrospective TRT data, and measure the impact of TRTs on children's general and cancer-related health-related quality of life (HRQoL) and parents' emotional well-being. METHODS: Parents of children with newly diagnosed ALL were invited to participate in the ASSET (Acute Lymphoblastic Leukaemia Subtypes and Side Effects from Treatment) study and a prospective, longitudinal HRQoL study. TRTs were reported prospectively and families completed questionnaires for general (Healthy Utility Index Mark 3) and cancer specific (Pediatric Quality of Life Inventory (PedsQL)-Cancer Module) health related quality of life as well the Emotion Thermometer to assess emotional well-being. RESULTS: Beginning in 2016, 260 pediatric patients with ALL were enrolled on the TRT registry with a median age at diagnosis of 59 months (range 1-213 months), 144 males (55.4%), majority with Pre-B cell immunophenotype, n = 226 (86.9%), 173 patients (66.5%) treated according to COG platform with relatively equal distribution across risk classification sub-groups. From 2018, 79 families participated in the HRQoL study through the first year of treatment. There were 74 TRT recorded, reflecting a 28.5% risk of developing a TRT. Individual TRT incidence was consistent with previous studies, being 7.7% for symptomatic VTE, 11.9% neurotoxicity, 5.4% bone toxicity and 5.0% pancreatitis. Children's HRQoL was significantly lower than population norms throughout the first year of treatment. An improvement in general HRQoL, measured by the HUI3, contrasted with the lack of improvement in cancer-related HRQoL measured by the PedsQL Cancer Module over the first 12 months. There were no persisting differences in the HRQoL impact of COG compared to iBFM therapy. CONCLUSIONS: It is feasible to prospectively monitor TRT incidence and longitudinal HRQoL impacts during ALL therapy. Early phases of ALL therapy, regardless of treatment platform, result in prolonged reductions in cancer-related HRQoL.
dc.format	Electronic
dc.language	eng
dc.publisher	Springer Nature
dc.relation.ispartof	BMC Cancer
dc.relation.isbasedon	10.1186/s12885-022-10072-x
dc.rights	info:eu-repo/semantics/openAccess
dc.subject	1112 Oncology and Carcinogenesis, 1117 Public Health and Health Services
dc.subject.classification	Oncology & Carcinogenesis
dc.subject.mesh	Acute Disease
dc.subject.mesh	Child
dc.subject.mesh	Humans
dc.subject.mesh	Male
dc.subject.mesh	Pancreatitis
dc.subject.mesh	Precursor Cell Lymphoblastic Leukemia-Lymphoma
dc.subject.mesh	Quality of Life
dc.subject.mesh	Retrospective Studies
dc.subject.mesh	Surveys and Questionnaires
dc.subject.mesh	Humans
dc.subject.mesh	Pancreatitis
dc.subject.mesh	Acute Disease
dc.subject.mesh	Retrospective Studies
dc.subject.mesh	Quality of Life
dc.subject.mesh	Child
dc.subject.mesh	Male
dc.subject.mesh	Precursor Cell Lymphoblastic Leukemia-Lymphoma
dc.subject.mesh	Surveys and Questionnaires
dc.subject.mesh	Acute Disease
dc.subject.mesh	Child
dc.subject.mesh	Humans
dc.subject.mesh	Male
dc.subject.mesh	Pancreatitis
dc.subject.mesh	Precursor Cell Lymphoblastic Leukemia-Lymphoma
dc.subject.mesh	Quality of Life
dc.subject.mesh	Retrospective Studies
dc.subject.mesh	Surveys and Questionnaires
dc.title	Prospective longitudinal evaluation of treatment-related toxicity and health-related quality of life during the first year of treatment for pediatric acute lymphoblastic leukemia.
dc.type	Journal Article
utslib.citation.volume	22
utslib.location.activity	England
utslib.for	1112 Oncology and Carcinogenesis
utslib.for	1117 Public Health and Health Services
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Strength - CHERE - Centre for Health Economics Research and Evaluation
pubs.organisational-group	/University of Technology Sydney/Strength - CHT - Health Technologies
pubs.organisational-group	/University of Technology Sydney/Centre for Health Technologies (CHT)
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/Centre for Health Economics Research and Evaluation
utslib.copyright.status	open_access	*
dc.date.updated	2023-04-13T01:27:43Z
pubs.issue	1
pubs.publication-status	Published online
pubs.volume	22
utslib.citation.issue	1

Abstract:

BACKGROUND: Pediatric acute lymphoblastic leukemia (ALL) therapy is accompanied by treatment-related toxicities (TRTs) and impaired quality of life. In Australia and New Zealand, children with ALL are treated with either Children's Oncology Group (COG) or international Berlin-Frankfurt-Munster (iBFM) Study Group-based therapy. We conducted a prospective registry study to document symptomatic TRTs (venous thrombosis, neurotoxicity, pancreatitis and bone toxicity), compare TRT outcomes to retrospective TRT data, and measure the impact of TRTs on children's general and cancer-related health-related quality of life (HRQoL) and parents' emotional well-being. METHODS: Parents of children with newly diagnosed ALL were invited to participate in the ASSET (Acute Lymphoblastic Leukaemia Subtypes and Side Effects from Treatment) study and a prospective, longitudinal HRQoL study. TRTs were reported prospectively and families completed questionnaires for general (Healthy Utility Index Mark 3) and cancer specific (Pediatric Quality of Life Inventory (PedsQL)-Cancer Module) health related quality of life as well the Emotion Thermometer to assess emotional well-being. RESULTS: Beginning in 2016, 260 pediatric patients with ALL were enrolled on the TRT registry with a median age at diagnosis of 59 months (range 1-213 months), 144 males (55.4%), majority with Pre-B cell immunophenotype, n = 226 (86.9%), 173 patients (66.5%) treated according to COG platform with relatively equal distribution across risk classification sub-groups. From 2018, 79 families participated in the HRQoL study through the first year of treatment. There were 74 TRT recorded, reflecting a 28.5% risk of developing a TRT. Individual TRT incidence was consistent with previous studies, being 7.7% for symptomatic VTE, 11.9% neurotoxicity, 5.4% bone toxicity and 5.0% pancreatitis. Children's HRQoL was significantly lower than population norms throughout the first year of treatment. An improvement in general HRQoL, measured by the HUI3, contrasted with the lack of improvement in cancer-related HRQoL measured by the PedsQL Cancer Module over the first 12 months. There were no persisting differences in the HRQoL impact of COG compared to iBFM therapy. CONCLUSIONS: It is feasible to prospectively monitor TRT incidence and longitudinal HRQoL impacts during ALL therapy. Early phases of ALL therapy, regardless of treatment platform, result in prolonged reductions in cancer-related HRQoL.

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http://hdl.handle.net/10453/169714