TY - JOUR
T1 - Comparison of psychologic outcome in adult survivors of childhood acute lymphoblastic leukemia versus sibling controls
T2 - A Cooperative Children's Cancer Group and National Institutes of Health Study
AU - Zeltzer, L. K.
AU - Chen, E.
AU - Weiss, R.
AU - Guo, M. D.
AU - Robison, L. L.
AU - Meadows, A. T.
AU - Mills, J. L.
AU - Nicholson, H. S.
AU - Byrne, J.
PY - 1997/1/1
Y1 - 1997/1/1
N2 - Purpose: To determine psychologic outcome, with the focus an emotional or mood state, of young adult survivors of childhood acute lymphoblastic leukemia (ALL) compared with sibling controls and to identify vulnerable subgroups at highest risk for negative mood. Patients and Methods: Adult survivors (n = 580), aged ≤ 18 years, who were treated before age 20 years on Children's Cancer Group (CCG) protocols for ALL and 396 sibling controls were administered a structured telephone interview and the Profile of Moods State (POMS), a standardized measure of affective state. Results: Survivors had higher total mood scores (which indicates greater negative mood) than sibling controls (P < .01) and reported more tension (P < .01), depression (P < .01), anger (P < .01), and confusion (P < .01), but not more fatigue or less vigor. Female, minority, and unemployed survivors reported the highest total mood disturbance. Overall, survivors were more likely to be unemployed (P < .05) or working less than half-time (P < .01) compared with controls. Conclusion: This large, sibling-controlled, multisite study of young adult survivors of childhood ALL treated on CCG protocols after 1970 found significant increased negative mood in survivors, not accounted for by reported energy level differences, which suggests that these emotional effects are not likely the result of current illness. Survivors are less likely to be fully employed. Female, minority, and unemployed survivors are at greatest risk for emotional sequelae, a finding that indicates the need for targeted, preventive intervention.
AB - Purpose: To determine psychologic outcome, with the focus an emotional or mood state, of young adult survivors of childhood acute lymphoblastic leukemia (ALL) compared with sibling controls and to identify vulnerable subgroups at highest risk for negative mood. Patients and Methods: Adult survivors (n = 580), aged ≤ 18 years, who were treated before age 20 years on Children's Cancer Group (CCG) protocols for ALL and 396 sibling controls were administered a structured telephone interview and the Profile of Moods State (POMS), a standardized measure of affective state. Results: Survivors had higher total mood scores (which indicates greater negative mood) than sibling controls (P < .01) and reported more tension (P < .01), depression (P < .01), anger (P < .01), and confusion (P < .01), but not more fatigue or less vigor. Female, minority, and unemployed survivors reported the highest total mood disturbance. Overall, survivors were more likely to be unemployed (P < .05) or working less than half-time (P < .01) compared with controls. Conclusion: This large, sibling-controlled, multisite study of young adult survivors of childhood ALL treated on CCG protocols after 1970 found significant increased negative mood in survivors, not accounted for by reported energy level differences, which suggests that these emotional effects are not likely the result of current illness. Survivors are less likely to be fully employed. Female, minority, and unemployed survivors are at greatest risk for emotional sequelae, a finding that indicates the need for targeted, preventive intervention.
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U2 - 10.1200/JCO.1997.15.2.547
DO - 10.1200/JCO.1997.15.2.547
M3 - Article
C2 - 9053476
AN - SCOPUS:0031017211
SN - 0732-183X
VL - 15
SP - 547
EP - 556
JO - Journal of Clinical Oncology
JF - Journal of Clinical Oncology
IS - 2
ER -