Survey of quality of life, phenotypic expression, and response to treatment in Krabbe leukodystrophy.

Published online

Journal Article

Objectives: To develop a quality of life (QOL) survey for Krabbe disease (KD), and to thereby improve understanding of its phenotypic expression and response to treatment. Methods: The survey, the Leukodystrophy Quality of Life Assessment (LQLA) and the Vineland Adaptive Behavior Scales were co-administered to 33 patients or their caretakers. These included the phenotypes of early infantile KD (EIKD; 0-6 months old at onset), late infantile cases (LIKD; 7-12 months old at onset), and cases that emerged after 12 months old, late onset (LOKD). The sample included cases with and without stem cell transplantation (SCT). Reliability and concurrent validity were assessed for overall and subscale scores. Analysis of variance tested differences in QOL between phenotypes and transplant groups (none, pre-, post-symptom). Results: Good concurrent validity with the Vineland was shown for total, communication, daily activity, social, and motor scales and good reliability was observed. LOKD cases had better communication skills than either EIKD or LIKD and better overall QOL than EIKD. Analyses of individual items showed that communication items, mostly, contributed significantly to phenotype differences. Presymptomatic SCT significantly improved QOL compared to postsymptomatic SCT or no treatment. Presymptomatically treated patients had near-normal total scores. Conclusions: The LQLA is valid and reliable. Despite small sample size, phenotypic demarcation was determined to be due mainly to differences in communication skills. There was a relative enhancement of QOL in LOKD patients, and in those who had presymptomatic SCT. These results apply to the current controversy about recommendations for newborn screening for this condition.

Full Text

Duke Authors

Cited Authors

  • Langan, TJ; Barczykowski, A; Jalal, K; Sherwood, L; Allewelt, H; Kurtzberg, J; Carter, RL

Published Date

  • May 2019

Published In

Volume / Issue

  • 47 / 1

Start / End Page

  • 47 - 54

PubMed ID

  • 31240167

Pubmed Central ID

  • 31240167

International Standard Serial Number (ISSN)

  • 2192-8304

Digital Object Identifier (DOI)

  • 10.1002/jmd2.12033

Language

  • eng

Conference Location

  • United States