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Multicenter Study
. 2008 Nov 26:6:103.
doi: 10.1186/1477-7525-6-103.

Effect of dexamethasone on quality of life in children with acute lymphoblastic leukaemia: a prospective observational study

Machteld A G de Vries  1 , Raphaële R L van Litsenburg, Jaap Huisman, Martha A Grootenhuis, A Birgitta Versluys, Gert Jan L Kaspers, Reinoud J B J Gemke
Affiliations
Multicenter Study

Effect of dexamethasone on quality of life in children with acute lymphoblastic leukaemia: a prospective observational study

Machteld A G de Vries et al. Health Qual Life Outcomes. .

Abstract

Background: Glucocorticoids are important in the treatment of childhood acute lymphoblastic leukaemia (ALL). However, cyclic administration of high dose glucocorticoids may cause rapid and substantial changes in quality of life (QoL). The maintenance phase of the Dutch ALL-9 protocol consisted of alternating two weeks on and five weeks off dexamethasone (6 mg/m(2)/day). The present study was performed to assess the effect of dexamethasone on QoL during treatment for ALL according to this protocol.

Methods: In a multicentre prospective cohort study, QoL was assessed halfway (T1) and at the end of the two-year treatment (T2). A generic (Child Health Questionnaire) and disease specific (PedsQL cancer version) QoL questionnaire were used to assess QoL in two periods: on and off dexamethasone, respectively.

Results: 41 children (56% males) were evaluated, mean age at diagnosis was 5.6 years. The CHQ physical and psychosocial summary scores were significantly lower than population norms. At T1 and T2, overall QoL showed no significant change. However, regarding specific domains (pain, cognitive functioning, emotion/behaviour and physical functioning) QoL decreased over time. QoL was significantly more impaired during periods on dexamethasone.

Conclusion: Dexamethasone was associated with decreased QoL. At the end of treatment, reported QoL during dexamethasone deteriorated even more on certain scales (pain, cognitive functioning, emotion/behaviour and physical functioning). Knowledge of the specific aspects of QoL is essential to improve counselling and coping in paediatric oncology. Adverse effects of specific drugs on QoL should be taken into account when designing treatment protocols.

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Figures

Figure 1
Figure 1
Study participation. * no participation at T2 because of: recurrence of leukaemia (n = 1) and not returning the questionnaires at T2 (n = 1). ** n = 2 were not treated with dexamethasone anymore because of serious corticosteroid related complications and only returned the off dexamethasone questionnaire.
See this image and copyright information in PMC

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