Effect of dexamethasone on quality of life in children with acute lymphoblastic leukaemia: a prospective observational study

被引:35
|
作者
de Vries, Machteld A. G. [1 ,2 ]
van Litsenburg, Raphaele R. L. [1 ,2 ]
Huisman, Jaap [3 ]
Grootenhuis, Martha A. [4 ]
Versluys, A. Birgitta [5 ]
Kaspers, Gert Jan L. [1 ,2 ]
Gemke, Reinoud J. B. J. [1 ,2 ]
机构
[1] Vrije Univ Amsterdam, Med Ctr, Dept Paediat, Amsterdam, Netherlands
[2] Vrije Univ Amsterdam, Med Ctr, Div Oncol Haematol, Amsterdam, Netherlands
[3] Vrije Univ Amsterdam, Med Ctr, Dept Med Psychol, Amsterdam, Netherlands
[4] Emma Childrens Hosp, Paediat Psychosocial Dept, Amsterdam, Netherlands
[5] Wilhelmina Childrens Hosp Univ, Med Ctr, Dept Paediat, Div Oncol Haematol, Utrecht, Netherlands
关键词
D O I
10.1186/1477-7525-6-103
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Background: Glucocorticoids are important in the treatment of childhood acute lymphoblastic leukaemia (ALL). However, cyclic administration of high dose glucocorticoids may cause rapid and substantial changes in quality of life (QoL). The maintenance phase of the Dutch ALL-9 protocol consisted of alternating two weeks on and five weeks off dexamethasone (6 mg/m(2)/day). The present study was performed to assess the effect of dexamethasone on QoL during treatment for ALL according to this protocol. Methods: In a multicentre prospective cohort study, QoL was assessed halfway (T1) and at the end of the two-year treatment (T2). A generic (Child Health Questionnaire) and disease specific (PedsQL (TM) cancer version) QoL questionnaire were used to assess QoL in two periods: on and off dexamethasone, respectively. Results: 41 children (56% males) were evaluated, mean age at diagnosis was 5.6 years. The CHQ physical and psychosocial summary scores were significantly lower than population norms. At T1 and T2, overall QoL showed no significant change. However, regarding specific domains (pain, cognitive functioning, emotion/behaviour and physical functioning) QoL decreased over time. QoL was significantly more impaired during periods on dexamethasone. Conclusion: Dexamethasone was associated with decreased QoL. At the end of treatment, reported QoL during dexamethasone deteriorated even more on certain scales (pain, cognitive functioning, emotion/behaviour and physical functioning). Knowledge of the specific aspects of QoL is essential to improve counselling and coping in paediatric oncology. Adverse effects of specific drugs on QoL should be taken into account when designing treatment protocols.
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页数:8
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