Poor patient-reported outcomes in survivors of childhood hematologic malignancies are associated with the presence of chronic health conditions, regardless of whether patients had received hematopoietic stem cell transplantation (HSCT) or conventional therapy, according to a study published in Blood.
Investigators compared symptom prevalence, health-related quality of life (HRQoL), and risk factors in adult survivors. In multivariate logistic regression analyses, these patient-reported outcomes were compared with results of surveys and medical assessments given to members of a noncancer control group (242 patients). Survivors of hematologic malignancies were organized by treatment type to either HSCT group (112 patients) or conventional treatment group (1106 patients).
Compared with individuals in the noncancer group, survivors who had received HSCT reported substantially higher rates of symptom prevalence across memory (adjusted odds ratio [aOR], 4.8), sensation (aOR, 4.7), pulmonary (aOR, 4.6), and motor/movement domains (aOR, 4.3). Physical HRQoL was also significantly worse for survivors who received HSCT, compared with patients who did not have cancer (aOR, 6.9).
The investigators found no significant difference between survivors from each treatment group in terms of HRQoL and symptom prevalence by domain. Organ-specific chronic health conditions were a greater indicator of the prevalence of most symptom domains than treatment type.
Some ocular symptoms showed higher cumulative prevalence among those who received HSCT compared with conventional treatment. These related to eye dryness (P <.0001), difficulty seeing while aided by glasses (P <.0001), and double vision (P =.04).
“The goal of cancer survivorship care is not merely to identify and manage medical complications, but also to improve daily functional status and HRQOL,” the investigators wrote.
The researchers also indicated that clinicians should consider proactively screening survivors of pediatric hematologic malignancies, particularly those treated with HSCT who have chronic health conditions, for symptoms phenotypes to aid in the early identification of adverse events.
Yen HJ, Eissa H, Bhatt NS, et al. Patient-reported outcomes in survivors of childhood hematologic malignancies with hematopoietic stem cell transplant [published online April 2, 2020]. Blood. doi: 10.1182/blood.2019003858