Parental functioning during maintenance treatment for childhood acute lymphoblastic leukemia: Effects of treatment intensity and dexamethasone pulses.

Autor: Rensen N; Princess Máxima Center for Pediatric Oncology, Utrecht, Netherlands.; Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, Pediatric Oncology, Cancer Center Amsterdam, Amsterdam, Netherlands., Steur LMH; Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, Pediatric Oncology, Cancer Center Amsterdam, Amsterdam, Netherlands., Grootenhuis MA; Princess Máxima Center for Pediatric Oncology, Utrecht, Netherlands., van Eijkelenburg NKA; Princess Máxima Center for Pediatric Oncology, Utrecht, Netherlands., van der Sluis IM; Princess Máxima Center for Pediatric Oncology, Utrecht, Netherlands.; Sophia Children's Hospital, Erasmus Medical Center, Pediatric Oncology, Rotterdam, Netherlands., Dors N; Princess Máxima Center for Pediatric Oncology, Utrecht, Netherlands.; Amalia Children's Hospital, Radboud University Medical Center, Pediatric Oncology, Nijmegen, Netherlands., van den Bos C; Princess Máxima Center for Pediatric Oncology, Utrecht, Netherlands.; Emma Children's Hospital, Amsterdam UMC, Academic Medical Center, Pediatric Oncology, Amsterdam, Netherlands., Tissing WJE; Princess Máxima Center for Pediatric Oncology, Utrecht, Netherlands.; University of Groningen, University Medical Center Groningen, Pediatric Oncology, Groningen, Netherlands., Kaspers GJL; Princess Máxima Center for Pediatric Oncology, Utrecht, Netherlands.; Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, Pediatric Oncology, Cancer Center Amsterdam, Amsterdam, Netherlands.; Dutch Childhood Oncology Group, Utrecht, Netherlands., van Litsenburg RRL; Princess Máxima Center for Pediatric Oncology, Utrecht, Netherlands.; Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, Pediatric Oncology, Cancer Center Amsterdam, Amsterdam, Netherlands.
Jazyk: angličtina
Zdroj: Pediatric blood & cancer [Pediatr Blood Cancer] 2020 Nov; Vol. 67 (11), pp. e28697. Date of Electronic Publication: 2020 Sep 10.
DOI: 10.1002/pbc.28697
Abstrakt: Background: During maintenance treatment, Dutch pediatric patients with medium-risk (MR) acute lymphoblastic leukemia (ALL) receive intravenous chemotherapy and cyclic dexamethasone. Dexamethasone affects child's sleep and behavior. Standard-risk (SR) patients only receive oral chemotherapy, without dexamethasone. Effects of stratified therapy on parents are not well known. This study compares parental sleep, distress and quality of life (QoL) with the general population, between MR and SR groups, and on- and off-dexamethasone (MR group).
Procedure: One year after diagnosis, parents of MR patients completed the Medical Outcomes Study (MOS) sleep, distress thermometer for parents and Short Form-12 (SF-12) twice; once on-dexamethasone and once off-dexamethasone. SR parents completed one measurement. Sleep problems, distress and QoL scores (off-dexamethasone) were compared to reference values and between MR and SR. Score differences on- and off-dexamethasone were assessed by multilevel regression analysis.
Results: Parents (80% mothers) of 121 patients (57% males; 75% MR, 25% SR) completed 191 measurements. Compared to reference values, parents reported more sleep disturbances, higher distress, and lower mental QoL. Additionally, MR parents reported clinical distress (score ≥ 4), whereas SR parents (on average) did not (mean 4.8 ± 2.4 vs 3.5 ± 2.4, P = .02). Within the MR group, outcomes did not significantly differ on- and off-dexamethasone.
Conclusions: Parents of ALL patients report sleep problems, high distress, and QoL impairment. Within the MR group, parental functioning did not differ on- and off-dexamethasone. However, MR parents reported clinical distress more often than SR parents, possibly reflecting differences in prognostic estimates and treatment burden. This perhaps includes the overall strain of cyclic dexamethasone. This study highlights the need for psychosocial support throughout treatment, regardless of risk stratification.
(© 2020 The Authors. Pediatric Blood & Cancer published by Wiley Periodicals LLC.)
Databáze: MEDLINE
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