Quality of life and physical function in adults treated with intensive chemotherapy for acute myeloid leukemia improve over time independent of age

被引:67
作者
Alibhai, Shabbir M. H. [1 ,2 ,3 ]
Breunis, Henriette [1 ]
Timilshina, Narhari [1 ]
Brignardello-Petersen, Romina [4 ]
Tomlinson, George [1 ,3 ,5 ]
Mohamedali, Hassanabbas [1 ]
Gupta, Vikas [1 ,2 ]
Minden, Mark D. [1 ,2 ]
Li, Madeline [6 ]
Buckstein, Rena [2 ,7 ]
Brandwein, Joseph M. [8 ]
机构
[1] Univ Hlth Network, Dept Med, Toronto, ON M5G 2C4, Canada
[2] Univ Toronto, Dept Med, Toronto, ON M5S 1A8, Canada
[3] Univ Toronto, Inst Hlth Policy Management & Evaluat, Toronto, ON M5T 3M6, Canada
[4] Univ Chile, Fac Dent, Evidence Based Dent Unit, Santiago 1058, Chile
[5] Univ Toronto, Dept Publ Hlth Sci, Toronto, ON M5T 3M6, Canada
[6] Univ Hlth Network, Dept Psychiat, Toronto, ON M5G 2C4, Canada
[7] Sunnybrook Hlth Sci Ctr, Dept Med Oncol, Toronto, ON M4N 3M5, Canada
[8] Univ Alberta, Dept Med, Edmonton, AB T6G 2G3, Canada
基金
加拿大健康研究院;
关键词
Acute myeloid leukemia; Chemotherapy; Aging; Quality of life; Physical function; Depression; Prospective study; Survivorship; PHYSIOLOGICAL-ASPECTS; CANCER MANAGEMENT; DECISION-MAKING; OLDER PATIENTS; SURVIVAL; FATIGUE; IMPACT; AML; MORTALITY; STRENGTH;
D O I
10.1016/j.jgo.2015.04.002
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Objectives: Intensive chemotherapy (IC) is the primary treatment of acute myeloid leukemia (AML) but is associated with significant toxicity, particularly in older adults. We characterized the impact of AML and its treatment on quality of life (QOL) and physical function in younger (age 18-59) and older (age 60+) patients with AML over 1 year from diagnosis. Materials and Methods: AML patients undergoing IC without stem-cell transplant at two tertiary care centers were enrolled in a prospective, longitudinal study. Assessments were done pre-IC and at 7 time points over the next year. QOL, fatigue, and physical performance (grip strength, 2-minute walk test (2MWT), timed chair stands) were measured in all patients whereas daily function was measured only in older patients. Data were analyzed using mixed effects regression models. Results: 237 patients were recruited (140 younger and 97 older, 56% male). One-year survival was 79% and 60% among younger and older patients, respectively. For patients in remission, global QOL and fatigue improved significantly over time (p < 0.001 for both); trends were similar between older and younger patients. Grip strength did not change over time (p = 0.58) whereas both the 2MWT (p < 0.001) and timed chair stands (p < 0.001) improved significantly. Daily function improved significantly over time (p = 0.003). Conclusions: Survivors of AML in remission after IC achieve significant improvements in QOL, fatigue, and physical function over time with similar trajectories for older and younger patients. These data suggest that appropriately selected older patients do well following IC. (C) 2015 Elsevier Ltd. All rights reserved.
引用
收藏
页码:262 / 271
页数:10
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