Pediatric lymphoma patients in Malawi present with poor health-related quality of life at diagnosis and improve throughout treatment and follow-up across all Pediatric PROMIS-25 domains

Details

• Alternative Title:
  Pediatr Blood Cancer
• Personal Author:
  Ellis, Grace K. ; Chapman, Hutton ; Manda, Agness ; Salima, Ande ; Itimu, Salama ; Banda, Grace ; Seguin, Ryan ; Manda, Geoffrey ; Butia, Mercy ; Huibers, Minke ; Ozuah, Nmazuo ; Tilly, Alyssa ; Stover, Angela M. ; Basch, Ethan ; Gopal, Satish ; Reeve, Bryce B. ; Westmoreland, Katherine D.
• Description:
  Background:
  
  Patient-reported outcomes (PROs) that assess health-related quality of life (HRQoL) are increasingly important components of cancer care and research that are infrequently used in sub-Saharan Africa (SSA).
  
  Methods:
  
  We administered the Chichewa Pediatric Patient-Reported Outcome Measurement Information System Pediatric (PROMIS)-25 at diagnosis, active treatment, and follow-up among pediatric lymphoma patients in Lilongwe, Malawi. Mean scores were calculated for the six PROMIS-25 HRQoL domains (Mobility, Anxiety, Depressive Symptoms, Fatigue, Peer Relationships, Pain Interference). Differences in HRQoL throughout treatment were compared using the minimally important difference (MID) and an ANOVA analysis. Kaplan-Meier survival estimates and Cox hazard ratios for mortality are reported.
  
  Results:
  
  Seventy-five children completed PROMIS-25 surveys at diagnosis, 35(47%) during active treatment, and 24(32%) at follow-up. The majority of patients died (n= 37, 49%) or were lost-to-follow-up (n=6, 8%). Most (n=51, 68%) were male, median age was 10 (IQR 8–12), 48/73 (66%) presented with advanced Stage III/IV, 61(81%) were diagnosed with Burkitt lymphoma and 14(19%) Hodgkin lymphoma. At diagnosis, HRQoL was poor across all domains, except for Peer Relationships. Improvements in HRQoL during active treatment and follow-up exceeded the MID. On exploratory analysis, fair-poor PROMIS Mobility<40 and severe Pain Intensity=10 at diagnosis were associated with increased mortality risk and worse survival, but not statistically significant.
  
  Conclusions:
  
  Pediatric lymphoma patients in Malawi present with poor HRQoL that improves throughout treatment and survivorship. Baseline PROMIS scores may provide important prognostic information. PROs offer an opportunity to include patient voices and prioritize holistic patient-centered care in low-resource settings.
  
  
• Subjects:
  Article Burkitt Lymphoma Child Female Follow-Up Studies Health-related Quality Of Life Hodgkin Lymphoma Humans Lymphoma Malawi Male Patient-reported Outcomes Patient Reported Outcome Measures Pediatric Oncology Quality Of Life Sub-Saharan Africa

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• Source:
  Pediatr Blood Cancer. 68(10):e29257
• Pubmed ID:
  34339099
• Pubmed Central ID:
  PMC8497011
• Document Type:
  Journal Article
• Funding:
  K01 TW009488/TW/FIC NIH HHSUnited States/ ; U54 CA190152/CA/NCI NIH HHSUnited States/ ; P30 CA016086/CA/NCI NIH HHSUnited States/ ; T32 GM086330/GM/NIGMS NIH HHSUnited States/ ; UM1 CA121947/CA/NCI NIH HHSUnited States/ ; D43 TW009340/TW/FIC NIH HHSUnited States/ ; K01 TW011191/TW/FIC NIH HHSUnited States/ ; U2G PS001965/PS/NCHHSTP CDC HHSUnited States/
• Volume:
  68
• Issue:
  10
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:f001e3e5eac8a83db56ecb83a4f14cb70dfdb007618c12e372c849f53a240508
• Download URL:
  https://stacks.cdc.gov/view/cdc/110551/cdc_110551_DS1.pdf
• File Type:
  [PDF - 1.21 MB ]