Health-related quality of life in adolescents at the time of diagnosis with osteosarcoma or acute myeloid leukemia

Abstract

Although measuring health-related quality of life (HRQoL) in adolescents with cancer helps clinicians to personalize care for their patients, no previous studies have included HRQoL measurement at the time of diagnosis of osteosarcoma (OS) or acute myeloid leukemia (AML). The purpose of this study was to evaluate the feasibility of measuring adolescents' HRQoL at the time of their diagnosis of OS or AML, and to compare their ratings with those of their parents and of similarly diagnosed but younger patients aged 8- to 12- years. Participants included 126 patients (79 adolescents) and 130 parents (78 parents of adolescents); most completed the HRQoL instrument/s within 48 hours of the first chemotherapy cycle. Ninety-three percent of adolescents diagnosed with OS and 93% of those diagnosed with AML completed the HRQoL instruments. Agreement between the adolescents and their parents ranged from 0.29 to 0.71 (OS) and 0.44 to 0.62 (AML). In all domains, OS adolescents had significantly lower PedsQL v.4.0 scores than adolescents with AML. Our findings demonstrates the feasibility of measuring HRQoL in adolescents with OS or AML (and their parents) at the time of diagnosis, and thus their HRQoL ratings can be used to inform their cancer care from diagnosis forward.

Health-Related Quality of Life in Children with Cancer

“…13,15,46,49 Children with ALL receiving maintenance treatment reported significantly lower HRQOL as compared to children at the completion of treatment. 54 However, there was a consensus among these studies that HRQOL steadily improved as children progressed in treatment, with highest HRQOL immediately after completion of treatment.…”

“…Studies that have assessed the impact of cancer diagnosis on HRQOL have conflicting results, with some studies showing a significant effect of diagnosis on HRQOL, and others reporting the cancer diagnosis as having little impact on HRQOL. 7,8,13,15,16,[39][40][41][42][43][44][45][46][47] Two studies found that children with ALL tend to report higher HRQOL than children with solid tumors or central nervous system (CNS) tumors, 13,15,39 while another study reported that children with ALL experience a lower HRQOL than other groups. 8 The poorest HRQOL was reported in children with AML and solid tumors, 15,48 while other studies reported finding no correlation between the type of cancer and HRQOL of children.…”

“…7,8,13,15,16,[39][40][41][42][43][44][45][46][47] Two studies found that children with ALL tend to report higher HRQOL than children with solid tumors or central nervous system (CNS) tumors, 13,15,39 while another study reported that children with ALL experience a lower HRQOL than other groups. 8 The poorest HRQOL was reported in children with AML and solid tumors, 15,48 while other studies reported finding no correlation between the type of cancer and HRQOL of children. 7,13,16,[39][40][41][42]46,49 Most of these studies measured HRQOL in a mixed sample of multiple, small diagnostic groups, thus proving difficult to interpret the effects of cancer type on the HRQOL outcome.…”

“…These factors include demographic, socio-economic status, diagnosis, treatment intensity and time in treatment. [13][14][15] The identification of these factors allowed the development of interventions mediating these factors in children with cancer. 1,14,16 Despite progress in improving HRQOL in children with cancer, most published studies provide incomplete information describing the impact of time and treatment.…”

“…The cross-sectional designs of most studies further hinder understanding the change with time. For example, two reviewed studies assessed HRQOL at the time of diagnosis, 15,16 while others chose a time point that was significant for the diagnostic group under study. 46,50,56 The fact that each diagnostic group had variability in treatment modality, intensity and timing made it difficult to draw comparisons or make assumptions regarding HRQOL across diagnoses.…”