title: Health status and quality of life of long-term survivors of childhood acute leukemia: the impact of central nervous system irradiation.
abstract: We evaluated the impact of central nervous system irradiation (CNSI) on long-term health status and quality of life (QoL) of childhood lymphoblastic leukemia survivors included in the French L.E.A. (Childhood and Adolescent Leukemia) multicentric cohort. QoL was self-reported in adults and assessed by parents in children and adolescents, using adapted questionnaires. From 2004 to 2009, 630 nongrafted patients were assessed after 11.8±6.3 years from diagnosis. Patients receiving CNSI (18.6%) or chemotherapy alone (81.4%) were compared. The risk of having long-term physical effects was increased with CNSI (odds ratio=3.3; 95% confidence interval, 1.8-5.9), especially regarding growth failure, second tumor, cataract, and overweight. QoL did not differ significantly according to the treatment received, despite a tendency toward lower scores with CNSI in children and adolescents (summary score 63.6±13.3 vs. 71.7±12.4, P=0.14). Compared with French norms, adult survivors had an impaired QoL, especially in mental domains (mental composite score 45.2±9.8 vs. 47.9±2.1, P<0.001). In pediatric survivors, QoL was not impaired and even tended to be higher than population norms (summary score 71.7±12.4 vs. 70.0±4.2, P=0.054), mainly in social and relational domains. In conclusion, QoL seems to be impaired by the trauma of a life-threatening illness in childhood, as well as by the treatment received.
authors.affiliation: Departments of *Pediatric Hematology-Oncology #Radiotherapy, APHM, La Timone Hospital, Marseille, Bouches du Rhône †Department of Public Health, EA 3279 Research Unit, University Hospital Marseille, Aix-Marseille University, Marseille ‡Department of Pediatric Hematology-Oncology, University Hospital of Nancy, Nancy, Meurthe-et-Moselle §Department of Pediatric Hematology-Oncology, CIC Inserm 501, University Hospital of Clermont-Ferrand, Clermont-Ferrand, Auvergne ∥Department of Pediatric Hematology-Oncology, University Hospital of Nice, Nice, Alpes Maritimes ¶Department of Pediatric Hematology-Oncology, University Hospital of Grenoble, Grenoble, Isère **Department of Pediatric Hematology-Oncology, University Hospital of Montpellier, Languedoc-Roussillon, France.
authors.forename: Joy
authors.initials: J
authors.lastname: Benadiba
authors.forename: Gérard
authors.initials: G
authors.lastname: Michel
authors.forename: Pascal
authors.initials: P
authors.lastname: Auquier
authors.forename: Pascal
authors.initials: P
authors.lastname: Chastagner
authors.forename: Justyna
authors.initials: J
authors.lastname: Kanold
authors.forename: Marilyne
authors.initials: M
authors.lastname: Poirée
authors.forename: Dominique
authors.initials: D
authors.lastname: Plantaz
authors.forename: Laetitia
authors.initials: L
authors.lastname: Padovani
authors.forename: Julie
authors.initials: J
authors.lastname: Berbis
authors.forename: Vincent
authors.initials: V
authors.lastname: Barlogis
authors.forename: Audrey
authors.initials: A
authors.lastname: Contet
authors.forename: Hervé
authors.initials: H
authors.lastname: Chambost
authors.forename: Nicolas
authors.initials: N
authors.lastname: Sirvent
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D001932:Brain Neoplasms / Q000209:etiology / Q000401:mortality / Q000523:psychology*; D002648:Child; D002675:Child, Preschool; D016371:Cranial Irradiation / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications / Q000523:psychology* / Q000532:radiotherapy; D011379:Prognosis; D011446:Prospective Studies; D011788:Quality of Life; D011795:Surveys and Questionnaires; D015996:Survival Rate; D017741:Survivors / Q000523:psychology*; D013995:Time; D055815:Young Adult