Health-related quality of life in children with childhood acute myeloid leukemia in China: A five-year prospective study
Tianhao Wu,
Wenfeng Fu,
Yao Xue,
Liwen Zhu,
Xiaopeng Ma,
Yuting Wei,
Huimin Li,
Yaping Wang,
Meiyun Kang,
Yongjun Fang,
Heng Zhang
Affiliations
Tianhao Wu
Department of Hematology and Oncology, Children's Hospital of Nanjing Medical University, Nanjing, 210008, China
Wenfeng Fu
Department of Hematology and Oncology, Children's Hospital of Nanjing Medical University, Nanjing, 210008, China
Yao Xue
Department of Hematology and Oncology, Children's Hospital of Nanjing Medical University, Nanjing, 210008, China
Liwen Zhu
Department of Hematology and Oncology, Children's Hospital of Nanjing Medical University, Nanjing, 210008, China
Xiaopeng Ma
Department of Hematology and Oncology, Children's Hospital of Nanjing Medical University, Nanjing, 210008, China
Yuting Wei
Department of Hematology and Oncology, Children's Hospital of Nanjing Medical University, Nanjing, 210008, China
Huimin Li
Department of Hematology and Oncology, Children's Hospital of Nanjing Medical University, Nanjing, 210008, China
Yaping Wang
Department of Hematology and Oncology, Children's Hospital of Nanjing Medical University, Nanjing, 210008, China
Meiyun Kang
Department of Hematology and Oncology, Children's Hospital of Nanjing Medical University, Nanjing, 210008, China
Yongjun Fang
Corresponding author. Department of Hematology and Oncology, Children's Hospital of Nanjing Medical University, Nanjing, 210008, China.; Department of Hematology and Oncology, Children's Hospital of Nanjing Medical University, Nanjing, 210008, China
Heng Zhang
Corresponding author. Department of Hematology and Oncology, Children's Hospital of Nanjing Medical University, Nanjing, 210008, China.; Department of Hematology and Oncology, Children's Hospital of Nanjing Medical University, Nanjing, 210008, China
Purpose: This study aims to identify the key factors influencing health-related quality of life (HRQoL) of pediatric acute myeloid leukemia (AML) patients following their initial diagnosis and examine their impact on the five-year survival prognosis. Methods: A chart review and follow-up were conducted for children with AML who participated in a prospective cohort study between 2017 and 2020. We identified factors influencing HRQoL through Pediatric Quality of Life Inventory™ (PedsQL™ 4.0), PedsQL™ Cancer Module 3.0 (CM 3.0) and PedsQL™ Family Impact Module 2.0 (FIM 2.0), as well as assessed the impact of impaired HRQoL on the overall outcomes of patients. Results: Sixty-four subjects enrolled in the study had complete HRQoL outcome data, and 61 of them completed the 5-year follow-up. In CM 3.0, age was positively associated with parental proxy reports (p = 0.040), whereas divorced families were negatively associated with child self-reports (p = 0.045). A positive medical history correlates with FIM 2.0 (p = 0.025). Residence (p = 0.046), the occupation of caregivers (p = 0.014), disease severity (p = 0.024), and the only child (p = 0.029) exhibited statistically significant associations with the impairment of HRQoL. Impaired HRQoL scores shown by the PedsQL™4.0 parent proxy report (p = 0.013) and FIM 2.0 (p = 0.011) were associated with a reduced 5-year survival rate. Conclusions: This study demonstrated that early impairment of HRQoL in pediatric acute myeloid leukemia patients has predictive value for long-term prognosis. Once validated, these findings may provide some guidance to clinicians treating children with AML.
