title: Patients' experience of chronic lymphocytic leukaemia: baseline health-related quality of life results from the LRF CLL4 trial.
abstract: We examined the effects of active untreated chronic lymphocytic leukaemia (CLL) on health-related quality of life (HRQoL), measured by the European Organization for Research and Treatment of Cancer quality of life questionnaire (EORTC QLQ-C30) at randomisation into the Leukaemia Research Fund CLL4 trial. Patients were scored 0-100 within each of 15 domains. A difference between groups of > or = 10 points was deemed clinically significant (asterisked * below). 431 valid baseline questionnaires were returned. Compared with population norms, patients had impaired HRQoL in 13/15 domains. The greatest differences were in fatigue*, sleep disturbance*, role functioning and global HRQoL. Fatigue was reported by 81% of patients, compared with the next most common symptoms: sleep disturbance (56%) and dyspnoea (49%). There was no association between spleen, liver or lymph node enlargement, or lymphocytosis and any HRQoL domain. Older age (> or =70 years) was associated with poorer physical functioning (P < 0.001) but fewer financial difficulties (P < 0.001*). Impairment of HRQoL at baseline was most apparent in stage A-progressive patients with B-symptoms and stage C patients with haemoglobin <120 g/l: compared with all others, these patients had poorer physical, role and social functioning, more fatigue and dyspnoea and poorer global HRQoL (all P < or = 0.001*). These findings support the recommendation to begin treatment when patients experience symptomatic disease, to improve HRQoL.
authors.affiliation: Section of Haemato-Oncology, The Institute of Cancer Research, Sutton, Surrey, UK.
authors.forename: Monica
authors.initials: M
authors.lastname: Else
authors.forename: Alastair G
authors.initials: AG
authors.lastname: Smith
authors.forename: Kim
authors.initials: K
authors.lastname: Cocks
authors.forename: Sue M
authors.initials: SM
authors.lastname: Richards
authors.forename: Shirley
authors.initials: S
authors.lastname: Crofts
authors.forename: Rachel
authors.initials: R
authors.lastname: Wade
authors.forename: Daniel
authors.initials: D
authors.lastname: Catovsky
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D016022:Case-Control Studies; D017281:Cost of Illness; D005221:Fatigue / Q000209:etiology / Q000523:psychology; D005260:Female; D006304:Health Status; D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000150:complications / Q000191:economics / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology / Q000523:psychology; D017060:Patient Satisfaction; D018579:Patient Selection; D011594:Psychometrics; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D018434:Sickness Impact Profile; D012893:Sleep Wake Disorders / Q000209:etiology / Q000523:psychology