Comparison of quality of life and health behaviors in survivors of acute leukemia and the general population
We aimed to compare the health-related quality of life and health behaviors of acute leukemia (AL) survivors with that of the general population from two cohorts. AL survivors (n = 149) completed a set of questionnaires to evaluate quality of life, mental status, and health behaviors. AL survivors had more physical and mental difficulties (problems with usual activities, 15% vs. 5%, p < 0.001; anxiety or depression, 24% vs. 9%, p < 0.001; pain, 35% vs. 20%, p = 0.002) and more financial difficulties (p < 0.001) than the general population. Survivors who received stem cell transplantation (SCT) had significantly worse problems with role functioning, fatigue, pain, dyspnea, and insomnia, and had higher depression scores than chemotherapy group (p = 0.024). In terms of health behaviors, AL survivors had lower rates of smoking and drinking and higher influenza vaccination rates than the general population. However, only 17% of survivors had been recommended to receive screening for other cancers from health-care providers, and 67% thought their risk for other cancers was equal or lower than that of the general population. Cancer screening rates were even lower in the SCT group than in the chemotherapy group (p = 0.041). Our study indicates that clinicians should establish more appropriate survivorship care plans.
KeywordsHealth-related quality of life Acute leukemia Hematopoietic stem cell transplantation
This study was supported by a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (grant number: HI14C1277).
Compliance with ethical standards
The institutional review boards of the participating institutions approved the study, and informed consent was obtained from all subjects.
Conflict of interest
The authors declare that they have no conflict of interest.
- 3.Zittoun R, Suciu S, Watson M, Solbu G, Muus P, Mandelli F, Stryckmans P, Peetermans M, Thaler J, Resegotti L, Dardenne M, Willemze R (1997) Quality of life in patients with acute myelogenous leukemia in prolonged first complete remission after bone marrow transplantation (allogeneic or autologous) or chemotherapy: a cross-sectional study of the EORTC-GIMEMA AML 8A trial. Bone Marrow Transplant 20:307–315. https://doi.org/10.1038/sj.bmt.1700888 CrossRefGoogle Scholar
- 5.Hjermstad M, Holte H, Evensen S, Fayers PM, Kaasa S (1999) Do patients who are treated with stem cell transplantation have a health-related quality of life comparable to the general population after 1 year? Bone Marrow Transplant 24:911–918. https://doi.org/10.1038/sj.bmt.1701998 CrossRefGoogle Scholar
- 12.Hjermstad MJ, Knobel H, Brinch L, Fayers PM, Loge JH, Holte H, Kaasa S (2004) A prospective study of health-related quality of life, fatigue, anxiety and depression 3-5 years after stem cell transplantation. Bone Marrow Transplant 34:257–266. https://doi.org/10.1038/sj.bmt.1704561 CrossRefGoogle Scholar
- 13.Andrykowski MA, Bishop MM, Hahn EA, Cella DF, Beaumont JL, Brady MJ, Horowitz MM, Sobocinski KA, Rizzo JD, Wingard JR (2005) Long-term health-related quality of life, growth, and spiritual well-being after hematopoietic stem-cell transplantation. J Clin Oncol 23:599–608. https://doi.org/10.1200/JCO.2005.03.189 CrossRefGoogle Scholar
- 15.Kopp M, Holzner B, Meraner V, Sperner-Unterweger B, Kemmler G, Nguyen-van-Tam DP, Nachbaur D (2005) Quality of life in adult hematopoietic cell transplant patients at least 5 yr after treatment: a comparison with healthy controls. Eur J Haematol 74:304–308. https://doi.org/10.1111/j.1600-0609.2004.00402.x CrossRefGoogle Scholar
- 16.Bevans MF, Marden S, Leidy NK, Soeken K, Cusack G, Rivera P, Mayberry H, Bishop MR, Childs R, Barrett AJ (2006) Health-related quality of life in patients receiving reduced-intensity conditioning allogeneic hematopoietic stem cell transplantation. Bone Marrow Transplant 38:101–109. https://doi.org/10.1038/sj.bmt.1705406 CrossRefGoogle Scholar
- 17.Messerer D, Engel J, Hasford J, Schaich M, Ehninger G, Sauerland C, Buchner T, Schumacher A, Krahl R, Niederwieser D, Krauter J, Ganser A, Creutzig U, Dohner H, Schlenk RF, for the German AML Intergroup (2008) Impact of different post-remission strategies on quality of life in patients with acute myeloid leukemia. Haematologica 93:826–833. https://doi.org/10.3324/haematol.11987 CrossRefGoogle Scholar
- 19.Andersson I, Ahlberg K, Stockelberg D, Brune M, Persson LO (2009) Health-related quality of life in patients undergoing allogeneic stem cell transplantation after reduced intensity conditioning versus myeloablative conditioning. Cancer Nurs 32:325–334. https://doi.org/10.1097/NCC.0b013e31819b5c81 CrossRefGoogle Scholar
- 20.Gupta V, Panzarella T, Li L, Khan J, Sharma A, Lipton JH, Kuruvilla J, Messner H, Alibhai SMH (2012) A prospective study comparing the outcomes and health-related quality of life in adult patients with myeloid malignancies undergoing allogeneic transplantation using myeloablative or reduced-intensity conditioning. Biol Blood Marrow Transplant 18:113–124. https://doi.org/10.1016/j.bbmt.2011.05.022 CrossRefGoogle Scholar
- 21.Fayers P, Aaronson N, Bjordal K (2001) The EORTC QLQ-C30 scoring manual, ed 3. European Organization for Research and Treatment of Cancer, BrusselsGoogle Scholar
- 24.Yun YH, Park YS, Lee ES, Bang SM, Heo DS, Park SY, You CH, West K (2004) Validation of the Korean version of the EORTC QLQ-C30. Qual Life Res 13:863–868. https://doi.org/10.1023/B:QURE.0000021692.81214.70 CrossRefGoogle Scholar
- 27.Frank SH, Zyzanski SJ (1988) Stress in the clinical setting: the Brief Encounter Psychosocial Instrument. J Fam Pract 26:533–539Google Scholar
- 28.Oh SM, Min KJ, Park DB (1999) A study on the standardization of the hospital anxiety and depression scale for Koreans: a comparison of normal, depressed and anxious groups. J Korean Neuropsychiatr Assoc 38:289–296Google Scholar
- 30.Busby DM, Christensen C, Crane DR, Larson JH (1995) A revision of the dyadic adjustment scale for use with distressed and nondistressed couples: construct hierarchy and multidimensional scales. J Marital Fam Ther 21:289–308. https://doi.org/10.1111/j.1752-0606.1995.tb00163.x CrossRefGoogle Scholar
- 31.Cho H, Choi SM, Oh HJ, Kwon JH (2011) Validity of the short forms of the Korean dyadic adjustment scale. Korean J Couns Psychother 23:655–670Google Scholar
- 32.Smilkstein G, Ashworth C, Montano D (1982) Validity and reliability of the family APGAR as a test of family function. J Fam Pract 15:303–311Google Scholar
- 33.Suh KJ, Kim I, Lim J, Ha H, Park S, Koh Y, Yoon SS, Park S (2015) Total costs and clinical outcome of hematopoietic stem cell transplantation in adults with leukemia: comparison between reduced-intensity and myeloablative conditioning. Clin Transpl 29:124–133. https://doi.org/10.1111/ctr.12492 CrossRefGoogle Scholar
- 34.Ghimire KB, Shah BK (2014) Second primary malignancies in adult acute myeloid leukemia—a US population-based study. Anticancer Res 34:3855–3859Google Scholar