title: Determinants of quality of life during induction therapy in pediatric acute lymphoblastic leukemia.
abstract: OBJECTIVE
  Improvement in survival of pediatric acute lymphoblastic leukemia (ALL) has increased the attention to quality of life (QoL) . QoL is impaired during maintenance treatment, but little is known about QoL during induction therapy. Identification of patients with poor QoL during induction will provide opportunities for early interventions, and may subsequently improve future QoL. This national multi-center study aimed to assess QoL and its determinants during ALL induction treatment.
  
  
  METHODS
  Proxy reports of the Child Health Questionnaire (CHQ) and the PedsQL cancer version were collected. Child, treatment, and parental characteristics were analyzed as potential determinants in a multiple regression model.
  
  
  RESULTS
  One hundred thirty parents of children participated (response rate 82 %), median child age was 5.7 years and 48 % were female. QoL, as measured with the CHQ, was significantly lower than the norm, the effect sizes were large, and the differences were clinically relevant. Physical QoL was more often affected than psychosocial QoL. Regression models could be constructed for 4/ 10 CHQ scales and 6/ 8 PedsQL cancer scales, accounting for 7 to 36 % of the variance in scores. Impaired QoL was most often associated with older children, girls, and time since diagnosis. Also, father respondents seem to have a lower QoL perception compared to mother respondents although this needs to be confirmed in future research.
  
  
  CONCLUSIONS
  Specific counseling for subsets of patients with a higher risk of low QoL during the early phases of therapy is warranted.
authors.affiliation: Department of Pediatrics, VU University Medical Center Amsterdam, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands, litsenburg@vumc.nl.
authors.forename: Raphaële R L
authors.initials: RR
authors.lastname: van Litsenburg
authors.forename: Jaap
authors.initials: J
authors.lastname: Huisman
authors.forename: Rob
authors.initials: R
authors.lastname: Pieters
authors.forename: Chris
authors.initials: C
authors.lastname: Verhaak
authors.forename: Gertjan J L
authors.initials: GJ
authors.lastname: Kaspers
authors.forename: Reinoud J B J
authors.initials: RJ
authors.lastname: Gemke
mesh_terms: D017668:Age of Onset; D002648:Child; D002654:Child Care / Q000379:methods / Q000458:organization & administration / Q000523:psychology; D002675:Child, Preschool; D005260:Female; D006801:Humans; D060828:Induction Chemotherapy / Q000379:methods / Q000523:psychology; D008137:Longitudinal Studies; D008297:Male; D020380:Needs Assessment; D020360:Neoadjuvant Therapy; D009426:Netherlands / Q000453:epidemiology; D010290:Parents / Q000523:psychology*; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000453:epidemiology / Q000523:psychology / Q000628:therapy; D011446:Prospective Studies; D019727:Proxy; D011788:Quality of Life; D012307:Risk Factors; D012737:Sex Factors; D011795:Surveys and Questionnaires