Childhood Cancer Symptom Cluster: Leukemia and Health-Related Quality of Life.

Journal Article (Journal Article)


To examine the relationship of the Childhood Cancer Symptom Cluster-Leukemia (CCSC-L) with health-related quality of life (HRQOL).

Sample & setting

327 children receiving treatment for acute lymphoblastic leukemia from four pediatric oncology programs across the United States.

Methods & variables

Participants completed fatigue, sleep disturbance, pain, nausea, and depression symptom questionnaires at four time points; these symptoms comprised the CCSC-L. HRQOL was measured at the start of postinduction therapy and then at the start of maintenance therapy. Relationships between the CCSC-L and HRQOL scores were examined with longitudinal parallel-process modeling.


The mean HRQOL significantly increased over time (p < 0.001). The CCSC-L had a significant negative association with HRQOL scores at the start of postinduction therapy (beta = -0.53, p < 0.005) and the start of maintenance therapy (beta = -0.33, p < 0.015). Participants with more severe symptoms in the CCSC-L over time had significantly lower HRQOL at the start of maintenance therapy (beta = -0.42, p < 0.005).

Implications for nursing

Nurses are pivotal in providing management strategies to minimize symptom severity that may improve HRQOL.

Full Text

Duke Authors

Cited Authors

  • Rodgers, CC; Hooke, MC; Taylor, OA; Koerner, KM; Mitby, PA; Moore, IM; Scheurer, ME; Hockenberry, MJ; Pan, W

Published Date

  • March 2019

Published In

Volume / Issue

  • 46 / 2

Start / End Page

  • 228 - 237

PubMed ID

  • 30767969

Pubmed Central ID

  • PMC8106538

Electronic International Standard Serial Number (EISSN)

  • 1538-0688

International Standard Serial Number (ISSN)

  • 0190-535X

Digital Object Identifier (DOI)

  • 10.1188/19.onf.228-237


  • eng