Health-related quality of life in children with chronic myeloid leukemia in the chronic phase

Fangyuan Zheng; Xuelin Dou; Liqiang Zhang; Jie Jin; Yanli Zhang; Bingcheng Liu; Li Meng; Xiaofan Zhu; Zesheng Lu; Yueping Jia; Huilan Liu; Hai Lin; Li Zhou; Xielan Zhao; Wei Yang; Hui Sun; Sixuan Qian; Hongxia Ma; Runhui Wu; Leping Zhang; Qian Jiang

doi:10.1007/s00432-021-03832-y

Health-related quality of life in children with chronic myeloid leukemia in the chronic phase

J Cancer Res Clin Oncol. 2022 Feb;148(2):341-350. doi: 10.1007/s00432-021-03832-y. Epub 2021 Oct 29.

Authors

Fangyuan Zheng^#¹, Xuelin Dou^#², Liqiang Zhang³, Jie Jin⁴, Yanli Zhang⁵, Bingcheng Liu⁶, Li Meng⁷, Xiaofan Zhu⁶, Zesheng Lu⁸, Yueping Jia¹, Huilan Liu⁹, Hai Lin¹⁰, Li Zhou¹¹, Xielan Zhao¹², Wei Yang¹³, Hui Sun¹⁴, Sixuan Qian¹⁵, Hongxia Ma¹⁶, Runhui Wu³, Leping Zhang¹⁷, Qian Jiang^{18

19}

Affiliations

¹ Department of Pediatrics, Peking University People's Hospital, No. 11 Xizhimen South Street, Beijing, 100044, China.
² Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, No. 11 Xizhimen South Street, Beijing, 100044, China.
³ Hematology and Oncology Center, Beijing Children's Hospital Affiliated to Capital Medical University, Beijing, China.
⁴ Department of Hematology, Zhejiang University First Affiliated Hospital, Zhejiang, China.
⁵ Department of Hematology, Henan Cancer Hospital, Henan, China.
⁶ Chinese Academy of Medical Sciences and Peking Union Medical College, Institute of Hematology and Blood Diseases Hospital, Tianjin, China.
⁷ Department of Hematology, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Hubei, China.
⁸ Guangdong Provincial People's Hospital, Guangdong Provincial Geriatrics Institute Guangzhou, Guangdong, China.
⁹ Department of Hematology, The First Affiliated Hospital of University of Science and Technology of China: Anhui Provincial Hospital, Anhui, China.
¹⁰ Department of Hematology and Oncology, Jilin University First Hospital, Jilin, China.
¹¹ Shanghai Jiao Tong University Medical School Affiliated Ruijin Hospital, Shanghai Institute of Hematology, Shanghai, China.
¹² Department of Hematology, Xiangya Hospital Central South University, Hunan, China.
¹³ Department of Hematology, Shengjing Hospital of China Medical University, Liaoning, China.
¹⁴ Department of Hematology, Zhengzhou University First Affiliated Hospital, Henan, China.
¹⁵ Department of Hematology, Nanjing Medical University Affiliated Nanjing Hospital: Nanjing First Hospital, Jiangsu, China.
¹⁶ Department of Hematology, The Third People's Hospital of Zhengzhou, Suzhou, Henan, China.
¹⁷ Department of Pediatrics, Peking University People's Hospital, No. 11 Xizhimen South Street, Beijing, 100044, China. zhangleping@pkuph.edu.cn.
¹⁸ Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, No. 11 Xizhimen South Street, Beijing, 100044, China. jiangqian@medmail.com.cn.
¹⁹ Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China. jiangqian@medmail.com.cn.

^# Contributed equally.

PMID: 34714411
DOI: 10.1007/s00432-021-03832-y

Abstract

Purpose: This study aimed to explore the health-related quality of life (HRQoL) and associated variables in children with chronic myeloid leukemia in the chronic phase (CML-CP) receiving tyrosine kinase inhibitors (TKIs).

Methods: A cross-sectional questionnaire was given to children with CML and their parents, who were < 18 years at diagnosis of CML and < 19 years at study. The questionnaire comprised three parts, including demographic information, clinical information, and the Chinese version of Pediatric Quality of Life Inventory^™ (PedsQL^™) Cancer Module 3.0 as HRQoL questionnaire.

Results: A total of 240 respondents data were analyzed. Multivariate analysis showed that children with symptoms had worse pain (- 10.2; P < 0.001), nausea (- 17.3; P = 0.001), more treatment anxiety (- 7.2; P = 0.005), worse self-assessment appearance (- 7.1; P = 0.001), communication problems (- 6.4; P = 0.001), and worse HRQoL (- 7.0; P < 0.001). Children with mothers having low educational qualifications had worse pain (- 6.0; P = 0.014), more worried about future (- 5.4; P = 0.042), worse cognition problems (- 7.1; P = 0.002), worse communication problems (- 5.5; P = 0.008), and worse HRQoL (- 4.3; P = 0.005). Younger age children at study had more procedural anxiety (2.7; P = 0.001), treatment anxiety (- 1.7; P = 0.014) and cognition problem (3.6; P < 0.001), as well as worse HRQoL (1.8; P = 0.008). However, older age children at diagnosis were more worried about future (- 2.8; P = 0.001), worse self-assessment appearance (- 1.1; P = 0.042) and worse HRQoL (- 1.8; P = 0.007). Other variables significantly associated with worse HRQoL included female gender, rural household registration and their father's low education level. Parents reported more gastrointestinal disorders, were worried about the future and had less concern about appearance than their children.

Conclusions: Female gender, older age at diagnosis, younger age at study, lower mother's education level, and TKI-related symptoms are significantly associated with worse HRQoL in Children with CML. Children and their parents have different priorities in the HRQoL.

Keywords: Children; Chronic myeloid leukemia; Health-related quality of life.

MeSH terms

Adolescent
Child
Child, Preschool
China / epidemiology
Comorbidity
Cross-Sectional Studies
Female
Humans
Leukemia, Myeloid, Chronic-Phase / epidemiology*
Leukemia, Myeloid, Chronic-Phase / pathology
Male
Quality of Life*
Surveys and Questionnaires