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Survival-weighted health profile for long-term survivors of acute myelogenous leukemia

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Abstract

The objective of this study was to use survival-weighted psychometric scores (SWPS) to construct a ‘health profile’ for long-term survivors of acute myelogenous leukemia (AML). The study cohort included all patients who had been diagnosed and treated in our institution from 1985 to 1999 and achieved complete remission after standard chemotherapy (n = 259). One hundred and four patients were interviewed by the European Organization for the Research and Treatment of Cancer (EORTC)-QLQ-C30 questionnaire and the brief form of World Health Organization quality of life questionnaire (WHOQOL-BREF) to estimate the quality of life (QOL) function of the cohort. Forty-one patients underwent bone marrow transplantation (BMT) as consolidation or salvage therapy; 63 received chemotherapy alone. SWPS for every functioning domain and symptom item was obtained by direct integration of the mean QOL function with the survival function of the cohort. A Monte Carlo method was used to extrapolate the life-long SWPS beyond the follow-up limit. The mean scores of EORTC-QLQ-C30 and WHOQOL-BREF did not differ significantly between patients who received BMT or those who received chemotherapy only (p > 0.01). In mean SWPS, patients who received BMT had significantly (p < 0.01) better SWPS in all of the functioning domains and symptom items of EORTC-QLQ-C30 and all four domains of WHOQOL-BREF. However, when the life-long extrapolation of SWPS was made, these differences diminished in global health and several symptom items of EORTC-QLQ-C30 as well as in the social and environmental domains of WHOQOL-BREF. Patients' perspective on QOL may be domain-specific and may evolve over time. SWPS may be useful to evaluate the efficacy of different treatment strategies for AML. Confirmation of the relative merit of BMT vs. chemotherapy alone from prospective studies is needed.

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References

  1. Lee SJ, Earle CC, Weeks JC. Outcome research in oncology: History, conceptual framework, and trends in the literature. J Natl Cancer Inst 2000; 92: 195–204.

    Google Scholar 

  2. Gotay CC, Muraoka MY. Quality of life in long-term survivors of adult-onset cancers. J Natl Cancer Inst 1998; 90: 656–667.

    Google Scholar 

  3. Glasziou PP, Simes RJ, Gelber RD. Quality adjusted survival analysis. Stat Med 1990; 9: 1259–1276.

    Google Scholar 

  4. Cole BF, Gelber RD, Kirkwood JM, Goldhirsch A, Barylak E, Borden E. Quality-of-life adjusted survival analysis of interferon alfa-2b adjuvant treatment of high-risk resected cutaneous melanoma: An Eastern Cooperative Oncology Group study. J Clin Oncol 1996; 14: 2666–2673.

    Google Scholar 

  5. Goldhirsch A, Gelber RD, Simes RJ, Glasziou P, Coates AS. Costs and benefits of adjuvant therapy in breast cancer: A quality-adjusted survival analysis. J Clin Oncol 1989; 7: 36–44.

    Google Scholar 

  6. Parsons SK, Gelber S, Cole BF, et al. Quality-adjusted survival after treatment for acute myeloid leukemia in childhood: A Q-TWiST analysis of the pediatric oncology group study 8821. J Clin Oncol 1999; 17: 2144–2152.

    Google Scholar 

  7. Mounier N, Haioun C, Cole BF, et al. Quality of life-adjusted survival analysis of high-dose therapy with autologous bone marrow transplantation versus sequential chemotherapy for patients with aggressive lymphoma in first complete remission. Blood 2000; 95: 3687–3692.

    Google Scholar 

  8. Hwang JS, Tsauo JY, Wang JD. Estimation of expected quality adjusted survival by cross-sectional survey. Stat Med 1996; 15: 93–102.

    Google Scholar 

  9. Hwang JS, Wang JD. Monte Carlo estimation of extrapolation of quality-adjusted survival for follow-up studies. Stat Med 1999; 18: 1627–1640.

    Google Scholar 

  10. Tsauo JY, Hwang JS, Chiu WT, Hung CC, Wang JD. Estimation of expected utility gained from the helmet law in Taiwan by quality-adjusted survival time. Accident Anal Prev 1999; 31: 253–263.

    Google Scholar 

  11. Armitage JO. Bone marrow transplantation. N Engl J Med 1994; 330: 827–838.

    Google Scholar 

  12. Appelbaum FR, Fisher LD, Thomas ED, et al. Chemotherapy vs. marrow transplantation for adults with acute nonlymphocytic leukemia: A five-year follow-up. Blood 1988; 72: 179–184.

    Google Scholar 

  13. Reiffers J, Gaspard MH, Maraninchi D, et al. Comparison of allogeneic or autologous bone marrow transplantation and chemotherapy in patients with acute myeloid leukaemia in first remission: A prospective controlled trial. Br J Haematol 1989; 72: 57–63.

    Google Scholar 

  14. Zittoun RA, Mandelli F, Willemze R, et al. Autologous or allogeneic bone marrow transplantation compared with intensive chemotherapy in acute myelogenous leukemia. N Engl J Med 1995; 332: 217–223.

    Google Scholar 

  15. Harousseau JL, Cahn JY, Pignon B, et al. Comparison of autologous bone marrow transplantation and intensive chemotherapy as postremission therapy in adult acute myeloid leukemia. Blood 1997; 90: 2978–2986.

    Google Scholar 

  16. Cassileth PA, Harrington DP, Appelbaum FR, et al. Chemotherapy compared with autologous or allogeneic bone marrow transplantation in the management of acute myeloid leukemia in first remission. N Engl J Med 1998; 339: 1649–1656.

    Google Scholar 

  17. Syrjala KL, Chapko MK, Vitaliano PP, Cummings C, Sullivan KM. Recovery after allogeneic marrow transplantation: Prospective study of predictors of long-term physical and psychosocial functioning. Bone Marrow Transplant 1993; 11: 319–327.

    Google Scholar 

  18. McQuellon RP, Russel GB, Rambo TD, et al. Quality of life and psychological distress of bone marrow transplant recipients: The 'time trajectory' to recovery over the first year. Bone Marrow Transplant 1998; 21: 477–486.

    Google Scholar 

  19. Neitzert CS, Ritvo P, Dancey J, Weiser K, Murray C, Avery J. The psychosocial impact of bone marrow transplantation: A review of the literature. Bone Marrow Transplant 1998; 22: 409–422.

    Google Scholar 

  20. Burnett AK. Transplantation in first remission of acute myeloid leukemia. N Eng J Med 1998; 339: 1698–1700.

    Google Scholar 

  21. Zittoun R, Suciu S, Watson M, et al. Quality of life in patients with acute myelogenous leukemia in prolonged first complete remission after bone marrow transplantation (allogeneic or autologous) or chermotherapy: A cross sectional study of the EORTC-GIMEMA AML 8A trial. Bone Marrow Transplant 1997; 20: 307–315.

    Google Scholar 

  22. Aaronson NK, Ahmedzai S, Bergman B, et al. The European Organization for Research and Treatment of Cancer QLQ-C30: A quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 1993; 85: 365–376.

    Google Scholar 

  23. Ringdal GI, Ringdal K. Testing the EORTC Quality of Life Questionnaire on cancer patients with heterogeneous diagnoses. Qual Life Res 1993; 2: 129–140.

    Google Scholar 

  24. Ringdal K, Ringdal KI, Kaasa S, et al. Assessing the consistency of psychometric properties of the HRQoL scales within the EORTC QLQ-C30 across populations by means of the Mokken scaling method. Qual Life Res 1999; 8: 25–43.

    Google Scholar 

  25. The WHOQOL group. The World Health Organization quality of life assessment (WHOQOL): Development and general psychometric properties. Soc Sci Med 1998; 46: 1569–1585.

    Google Scholar 

  26. 26. The WHOQOL group. Development of the World Health Organization WHOQOL-BREF quality of life assessment. Psychol Med 1998; 28: 551–558.

    Google Scholar 

  27. Bullinger M. Ensuring international equivalence of quality of life measures: Problems and approaches to solutions. In: Orley J, Kuyken W (eds), Quality of Life Assessment: International Perspectives, Heidelberg: Springer-Verlag, 1994.

    Google Scholar 

  28. Lin MR, Yao KP, Hwang JS, Wang JD. Scale descriptor selection for Taiwan-version of questionnaire of World Health Organization quality of life. Chin J Pub Health (Taipei) 1999; 18: 262–270 (Chinese).

    Google Scholar 

  29. Fayers PM, Aaronson NK, Bjordal K, Curran D, Groenvold M. EORTC QLQ-C30: Scoring manual. 2nd edn. Brussel, Belgium: European Organization for Research and Treatment of Cancer Quality of Life Study Group, 1999.

    Google Scholar 

  30. World Health Organization. WHOQOL-BREF: Introduction, Administration, Scoring and Generic Version of the Assessment-field Trial Version. Geneva, 1996.

  31. Efron B, Tibshirani RJ. An Introduction to the Bootstrap. Chapman and Hall, New York, 1993.

    Google Scholar 

  32. Mangione CM, Goldman L, Orav EJ, et al. Health related quality of life after elective surgery. J Gen Intern Med 1997; 12: 686–697.

    Google Scholar 

  33. Velikova G, Wright P, Smith AB, et al. Self-reported quality of life of individual cancer patients: Concordance of results with disease course and medical records. J Clin Oncol 2001; 19: 2064–2073.

    Google Scholar 

  34. Mark DB, Hlatky MA, Califf RM, et al. Cost effectiveness of thrombolytic therapy with tissue plasminogen activator as compared with streptokinase for acute myocardial infarction. N Eng J Med 1995; 332: 1418–1424.

    Google Scholar 

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Authors and Affiliations

  1. Department of Oncology, National Taiwan University Hospital, Taiwan

    Chiun Hsu, Ann-Lii Cheng, Yao-Chang Chen & Jih-Luh Tang

  2. Department of Internal Medicine, National Taiwan University Hospital, Taiwan

    Chiun Hsu, Jung-Der Wang, Hwei-Fang Tien & Jih-Luh Tang

  3. Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University, College of Public Health, Taiwan

    Jung-Der Wang

  4. Institute of Statistical Science, Academia Sinica, Taiwan

    Jing-Shiang Hwang

  5. Department of Nursing, National Taiwan University Hospital, Taiwan

    Shueh-Mei Chang

  6. Department of Laboratory Medicine, National Taiwan University Hospital, Taiwan

    Yao-Chang Chen

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  1. Chiun Hsu
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Hsu, C., Wang, JD., Hwang, JS. et al. Survival-weighted health profile for long-term survivors of acute myelogenous leukemia. Qual Life Res 12, 503–517 (2003). https://doi.org/10.1023/A:1025043113819

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