Health-related quality of life among children with acute lymphoblastic leukemia

Background The objective was to quantify the health-related quality of life (HRQL) of children treated for acute lymphoblastic leukemia (ALL) and identify specific disabilities for remediation. Procedure Two types of subjects were included: ALL patients 5 plus years old in a multi-center clinical trial and general population control groups. Patients were assessed during all four major phases of active treatment and approximately 2 years after treatment. Health status and HRQL were measured using HEALTH UTILITIES INDEX (R) (HUI (R)) Mark 2 (HUI2) and Mark 3 (HUI3). HRQL scores were used to calculate quality-adjusted life years (QALYs). Excess disability rates identified attributes for remediation. Results HUI assessments (n?=?749) were collected during the five phases. Mean HRQL increased from induction through the post-treatment phase (P?<?0.001). There were no significant demographic or treatment effects on HRQL, except for type of asparaginase during continuation therapy (P?=?0.005 for HUI2 and P?=?0.007 for HUI3). Differences in mean HRQL scores between patients and controls were important (P?<?0.001) during the active treatment phases but not during the post-treatment phase. Relative to controls, patients lost approximately 0.2 QALYs during active treatment. Disability was evident in mobility/ambulation, emotion, self-care and pain, and declined over time. Conclusions Patients with ALL experienced important but declining deficits in HRQL during active treatment phases: Equivalent to losing approximately 2 months of life in perfect health. HRQL within the 2-years post-treatment phase was similar to controls. The policy challenge is to develop new treatment protocols producing fewer disabilities in mobility/ambulation, emotion, self-care, and pain without compromising survival. Pediatr Blood Cancer 2012;59:717724. (c) 2012 Wiley Periodicals, Inc.