title: Quality of life for adult leukemia survivors treated on clinical trials of Cancer and Leukemia Group B during the period 1971-1988: predictors for later psychologic distress.
abstract: BACKGROUND
  To identify predictors of psychosocial adjustment for survivors of adult acute leukemia, the adaptation of 206 survivors (77% with acute myelogenous leukemia, and 23% with acute lymphocytic leukemia) treated on any of 13 Cancer and Leukemia Group B trials during the period 1971-1988 was examined.
  
  
  METHODS
  Survivors (median age, 41 years) who were at least 1 year from completion of all treatment (median, 5 years) were interviewed by telephone about psychologic symptoms; social, sexual, and vocational function; and beliefs about control over health. Standardized psychologic instruments were used to evaluate survivors' responses.
  
  
  RESULTS
  Most survivors adapted well; however, 14% were 1.5 standard deviations above normal on the Global Severity Index of the Brief Symptom Inventory. Predictors of greater psychologic distress included less education, younger age, anticipatory distress during chemotherapy treatment, and the combination of more medical problems after treatment with poorer family function. Anticipatory nausea and distress during chemotherapy predicted persistent visceral distress later, which occurred with reminders of treatment. Anticipatory vomiting predicted a greater tendency toward cancer-related intrusive thoughts and avoidance of reminders.
  
  
  CONCLUSIONS
  Patients experiencing anticipatory distress during treatment who are younger and less educated should be monitored for depressive syndromes later.
authors.affiliation: Department of Psychiatry, Massachusetts General Hospital, Boston, USA.
authors.forename: D B
authors.initials: DB
authors.lastname: Greenberg
authors.forename: A B
authors.initials: AB
authors.lastname: Kornblith
authors.forename: J E
authors.initials: JE
authors.lastname: Herndon
authors.forename: E
authors.initials: E
authors.lastname: Zuckerman
authors.forename: C A
authors.initials: CA
authors.lastname: Schiffer
authors.forename: R B
authors.initials: RB
authors.lastname: Weiss
authors.forename: R J
authors.initials: RJ
authors.lastname: Mayer
authors.forename: S M
authors.initials: SM
authors.lastname: Wolchok
authors.forename: J C
authors.initials: JC
authors.lastname: Holland
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D000368:Aged; D001008:Anxiety Disorders / Q000209:etiology*; D002648:Child; D002986:Clinical Trials as Topic; D005260:Female; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000523:psychology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000523:psychology* / Q000628:therapy; D011788:Quality of Life