Health related quality of life and buffering factors in adult survivors of acute pediatric lymphoblastic leukemia and their siblings

Katarina Aili,Susann Arvidsson,Jens M Nygren

doi:10.1186/s12955-021-01700-4

Katarina Aili, Susann Arvidsson + Show 1 more

Open Access

https://doi.org/10.1186/s12955-021-01700-4

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Abstract

BackgroundThe improvement in treatment of pediatric acute lymphatic leukemia (ALL) has introduced new challenges for pediatric oncology care in understanding and handling long-term treatment-related complications later in adult life. The aim of this study was to describe health related quality of life (HRQoL) and the relation to buffering factors among young adult (YA) pediatric ALL survivors and their siblings.MethodsThis cross-sectional study was performed among 227 adults, treated for pediatric ALL in Sweden between 1985 and 1997 and their siblings (n = 70). Group means of HRQoL (SF-36) were compared between YA ALL survivors and the siblings, as well as to normative values from the general population. Self-efficacy (GSES) and social support (SS-13 subscale AVSI) was considering potential buffering factors for HRQoL and mental health. Associations between HRQoL and mental health respectively and self-efficacy and social support was analyzed.ResultsThe YA ALL survivors scored significantly lower on the HRQoL parameters general health (69.6 vs. 78.4, p = 0.004) and role emotional (77.1 vs. 88.1, p = 0.014), than the siblings. Further, they reported significantly lower general health (69.6 vs. 75.8), vitality (56.9 vs. 68.8), social functioning (84.5 vs. 88.6), role emotional (77.1 vs. 85.7) and mental health (71.3 vs. 80.9) compared with Swedish norms. Both YA ALL survivors and the siblings reported lower vitality and worse mental health than the general population. The HRQoL parameters, depression, stress and anxiety were all associated with both self-efficacy and social support among the YA ALL survivors. Among the siblings however, only general health, vitality, role emotional, mental health and depression were associated with social support, and only general health and mental health were associated with general self-efficacy.ConclusionThe results from this study show that buffering factors, like social support and self-efficacy, may play an important role for psychosocial outcomes and HRQoL among YA ALL survivors later in life. The results suggest that this group could benefit from continuous support in adult life to handle consequences of their pediatric disease.

Highlights

The improvement in treatment of pediatric acute lymphatic leukemia (ALL) has introduced new challenges for pediatric oncology care in understanding and handling long-term treatment-related complications later in adult life
In all, 227 young adult (YA) ALL survivors responded to the questionnaire and fulfilled the inclusion criteria
There was no difference in current age or age at diagnosis or years since diagnosis between respondents and non-respondents/excluded, between 14 and 27 years had passed since diagnosis for both groups

Summary

Introduction

The improvement in treatment of pediatric acute lymphatic leukemia (ALL) has introduced new challenges for pediatric oncology care in understanding and handling long-term treatment-related complications later in adult life. The prognosis has improved substantially and continually during the last 60 years due to improved treatment protocols. This has resulted in a Treatment protocols have improved to reduce treatment-related complications both during treatment and later in life [4]. Children with ALL do experience impairment in physical and mental health and in health-related quality of life (HRQoL) after completion of the up to 3-year-long treatment [5, 6].

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