Abstract
256 Background: Prior research reveals that AYA survivors face significant short-term and long-term physical and psychological symptom burdens (SB) as a result of disease and treatment. Yet, the prevalence of SB and their effect on AYA coping in hematologic survivors has not been described. Methods: AYA patients (15-40 years at diagnosis) of acute leukemia, aggressive non-Hodgkin lymphoma, and Hodgkin lymphoma undergoing curative intent therapy (on-treatment cohort) or 2 year completion of therapy and in remission (early survivor cohort) completed following measures: depression (CES-D), state anxiety (STAI-S), PTSD (PCL-C), HRQOL (FACIT-G), Coping (Brief COPE). Semi-structured interviews evaluated symptom burdens. Results: To date, 60 AYA subjects (26 on-treatment, 34 early survivors) were interviewed. For total population: median age at diagnosis 25y (15-40); 63% male; 58% Ca; 79% college/postgrad educated; 40% income < $75,000yr; 51% and 48% lymphoma or leukemia dx, respectively. Median time from diagnosis to interview was 13 months (1-102). In general, 56% AYA reported experiencing current physical (e.g. pain, sleep) SB and 58% AYA experienced psychological (e.g. anxiety) SB. AYA on treatment reported moderate STAI-S anxiety (35.0 ± 10.3 v 31 ± 10.2, p = 0.03); and CES-D depression (21 ± 12.1 v 10.4 ± 8.0, p = 0.01). AYA on treatment had poorer overall FACT-G health-related QOL (76.5 ± 12.8 v 82.3 ± 17.0, p = 0.02). Re coping, AYA on-treatment with depression scored highest on self-blame (5.2 ± 2.7; range: 3.5-6.8). AYA on-treatment with anxiety scored highest on denial (4.3 ± 2.1; range: 1-6). AYA in remission reported severe illness-related PTSD symptoms (58 ± 24.3 v 29.4 ± 9.5, p = 0.01). Re coping strategies, AYA in remission with PTSD scored on average significantly higher on: denial (6.5 ± 3.2; range 4.6-8.0); self-blame (6.6 ± 2.3; range: 4.2-7.9) and substance use (5.9 ± 2.1; range: 2.9-8.0). Conclusions: AYAs with hematologic malignancies report experiencing significant physical and psychological SB in the short and long-term. Early integration of palliative care targeting these SB should be incorporated into routine cancer as well as survivor care.
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