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Prospective patient-reported symptom profiles associated with pediatric acute lymphoblastic leukemia relapse.

Publication ,  Journal Article
Brown, AL; Raghubar, KP; Taylor, OA; Bernhardt, MB; Kahalley, LS; Pan, W; Lupo, PJ; Hockenberry, MJ; Scheurer, ME
Published in: Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer
May 2021

Despite improvements in frontline pediatric acute lymphoblastic leukemia (ALL) treatment, relapse remains a concern. Research in adult cancer patients suggests that patient-reported symptoms may predict survival, but the relationship between symptoms and relapse for pediatric ALL has received little attention.Pediatric patients with ALL (age 2-18 years) and/or their primary caregivers completed symptom surveys at the end of induction, start of delayed intensification (DI), start of maintenance cycle 1 (MC1), and start of maintenance cycle 2 (MC2). Symptom clusters for co-occurring fatigue, pain, sleep disruptions, and nausea were defined using latent profile analysis. Hazard ratios (HR) and 95% confidence intervals (CI) for the association between symptom clusters, individual symptoms, and subsequent relapse were calculated using multivariable Cox proportional hazards models, adjusting for clinical and demographic factors.Eligible patients (n = 208) were followed an average of 2.6 years for the incidence of relapse (n = 22). Associations between relapse and symptoms were identified for fatigue at DI (HR = 1.83, 95%CI 1.23-2.73) and MC1 (HR = 2.14, 95%CI 1.62-2.84), pain at DI (HR = 1.80, 95%CI 1.19-2.72), nausea at the end of induction (HR = 1.19, 95%CI 1.01-1.39), and sleep disturbances at the end of induction (HR = 2.00, 95%CI 1.11-3.62), DI (HR = 1.73, 95%CI 1.01-2.96), and MC1 (HR = 2.19, 95%CI 1.10-4.35). Symptom clusters comprised of individuals with a higher average symptom burden at DI were significantly (p < 0.05) associated with relapse.Patient-reported symptoms may provide prognostic information to aid in the identification of pediatric ALL patients at increased risk of relapse.

Duke Scholars

Published In

Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer

DOI

EISSN

1433-7339

ISSN

0941-4355

Publication Date

May 2021

Volume

29

Issue

5

Start / End Page

2455 / 2464

Related Subject Headings

  • Recurrence
  • Prospective Studies
  • Prognosis
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma
  • Patient Reported Outcome Measures
  • Oncology & Carcinogenesis
  • Male
  • Humans
  • Female
  • Child, Preschool
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Brown, A. L., Raghubar, K. P., Taylor, O. A., Bernhardt, M. B., Kahalley, L. S., Pan, W., … Scheurer, M. E. (2021). Prospective patient-reported symptom profiles associated with pediatric acute lymphoblastic leukemia relapse. Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer, 29(5), 2455–2464. https://doi.org/10.1007/s00520-020-05773-7
Brown, Austin L., Kimberly P. Raghubar, Olga A. Taylor, Melanie Brooke Bernhardt, Lisa S. Kahalley, Wei Pan, Philip J. Lupo, Marilyn J. Hockenberry, and Michael E. Scheurer. “Prospective patient-reported symptom profiles associated with pediatric acute lymphoblastic leukemia relapse.Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer 29, no. 5 (May 2021): 2455–64. https://doi.org/10.1007/s00520-020-05773-7.
Brown AL, Raghubar KP, Taylor OA, Bernhardt MB, Kahalley LS, Pan W, et al. Prospective patient-reported symptom profiles associated with pediatric acute lymphoblastic leukemia relapse. Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer. 2021 May;29(5):2455–64.
Brown, Austin L., et al. “Prospective patient-reported symptom profiles associated with pediatric acute lymphoblastic leukemia relapse.Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer, vol. 29, no. 5, May 2021, pp. 2455–64. Epmc, doi:10.1007/s00520-020-05773-7.
Brown AL, Raghubar KP, Taylor OA, Bernhardt MB, Kahalley LS, Pan W, Lupo PJ, Hockenberry MJ, Scheurer ME. Prospective patient-reported symptom profiles associated with pediatric acute lymphoblastic leukemia relapse. Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer. 2021 May;29(5):2455–2464.
Journal cover image

Published In

Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer

DOI

EISSN

1433-7339

ISSN

0941-4355

Publication Date

May 2021

Volume

29

Issue

5

Start / End Page

2455 / 2464

Related Subject Headings

  • Recurrence
  • Prospective Studies
  • Prognosis
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma
  • Patient Reported Outcome Measures
  • Oncology & Carcinogenesis
  • Male
  • Humans
  • Female
  • Child, Preschool