title: Headache types, related morbidity, and quality of life in survivors of childhood acute lymphoblastic leukemia: a prospective cross sectional study.
abstract: BACKGROUND
  Increased headache prevalence was recently reported in survivors of childhood ALL. Headache sub types, related morbidity, and effect on quality of life has not been reported thus far.
  
  
  OBJECTIVE
  To study headache prevalence and type, related disability, and quality of life in a cohort of childhood acute lymphoblastic leukemia (ALL) survivors.
  
  
  METHODS
  Childhood ALL survivors in at least 1-year of remission and 5 years from diagnosis completed questionnaires and were evaluated by a neurologist. Disability was evaluated with Pediatric Migraine Disability Assessment scale and the Short Form-36 Health Survey assessed quality of life.
  
  
  RESULTS
  Thirty nine of 72 (54%) females and 37 of 90 (41%) males reported headaches. Median time from ALL diagnosis to first headache was 5.2 years and median age at headache onset was 10.1 years in 76 participants with headache. Migraine headaches were diagnosed in 51 (31%) and episodic tension-type headaches in 49 (30%); migraine and tension-type headaches co-existed in 24 (15%) and 18 (11%) participants had chronic daily headaches. Fatigue was associated with migraine headache while hypertension and female gender associated with tension type headache. Headache-related disability was mild in 22 (29%), moderate in 7 (9%), and severe in 5 (7%) survivors, and was absent in the remaining 42 (55%) survivors with headache. Both migraine and tension type headaches associated with reduced mental component scores, while headache related disability associated with a reduced physical component scores.
  
  
  CONCLUSIONS
  Headaches are common in ALL survivors but only a minority has significant disability or impairment of quality of life.
authors.affiliation: Division of Neurology, St. Jude Children's Research Hospital, Memphis, TN, USA.
authors.forename: Zsila S
authors.initials: ZS
authors.lastname: Sadighi
authors.affiliation: Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, USA.
authors.forename: Kirsten K
authors.initials: KK
authors.lastname: Ness
authors.affiliation: Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, USA.
authors.forename: Melissa M
authors.initials: MM
authors.lastname: Hudson
authors.affiliation: Division of Neurology, St. Jude Children's Research Hospital, Memphis, TN, USA.
authors.forename: E Brannon
authors.initials: EB
authors.lastname: Morris
authors.affiliation: Division of Neurology, St. Jude Children's Research Hospital, Memphis, TN, USA.
authors.forename: Davonna S
authors.initials: DS
authors.lastname: Ledet
authors.affiliation: Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA.
authors.forename: Ching-Hon
authors.initials: CH
authors.lastname: Pui
authors.affiliation: Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA.
authors.forename: Scott C
authors.initials: SC
authors.lastname: Howard
authors.affiliation: Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, USA.
authors.forename: Kevin R
authors.initials: KR
authors.lastname: Krull
authors.affiliation: Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, USA.
authors.forename: Emily
authors.initials: E
authors.lastname: Browne
authors.affiliation: Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, USA.
authors.forename: Debbie
authors.initials: D
authors.lastname: Crom
authors.affiliation: Department of Nursing-Research, St. Jude Children's Research Hospital, Memphis, TN, USA; Division of Nursing Research at Children's National Medical Center, Washington D.C., USA.
authors.forename: Pamela S
authors.initials: PS
authors.lastname: Hinds
authors.affiliation: Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, TN, USA.
authors.forename: Liang
authors.initials: L
authors.lastname: Zhu
authors.affiliation: Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, TN, USA.
authors.forename: Deokumar
authors.initials: D
authors.lastname: Srivastava
authors.affiliation: Division of Neurology, St. Jude Children's Research Hospital, Memphis, TN, USA. Electronic address: raja.khan@stjude.org.
authors.forename: Raja B
authors.initials: RB
authors.lastname: Khan
mesh_terms: D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D006261:Headache / Q000145:classification / Q000453:epidemiology* / Q000209:etiology*; D006801:Humans; D008297:Male; D009017:Morbidity; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications / Q000453:epidemiology / Q000523:psychology; D015995:Prevalence; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology*; D011795:Surveys and Questionnaires
keywords: Acute lymphoblastic leukemia (ALL); Childhood; Headaches; Long-term survivor; Morbidity; Quality of life