Elsevier

Cancer Treatment Reviews

Volume 30, Issue 1, February 2004, Pages 103-117
Cancer Treatment Reviews

ANTI-TUMOUR TREATMENT
Short- and long-term effects of acute myeloid leukemia on patient health-related quality of life

https://doi.org/10.1016/S0305-7372(03)00142-7Get rights and content

Abstract

Objectives: Patients with acute myeloid leukemia (AML) may receive aggressive therapies (e.g., chemotherapy and bone marrow transplantation (BMT)) that are thought to significantly affect HRQL. Therefore, the goal of this study was to assess the HRQL impact on patients of AML and its treatments.

Materials and methods: An electronically assisted literature survey and synthesis was conducted of English-language literature published worldwide between 1990 and 2002. The review was enhanced by inclusion of articles, including those published before 1990, which were manually identified from the bibliographies of the electronically identified publications. Articles were analyzed with respect to HRQL instruments used, HRQL domains assessed, aspects of disease and treatment evaluated, and outcomes observed.

Results: The survey identified 21 articles that warranted review. AML and associated treatments have a substantial negative impact on patient HRQL as has been measured by several different leukemia-specific, cancer-specific and generic instruments. The most negative HRQL burden is apparent soon after the diagnosis of the disease and during the course of therapy. Long-term survivors appear to recover HRQL almost completely with respect to physical, psychological and emotional well being, but incur continued sexual dysfunction.

Conclusion: Clinicians responsible for the care of patients with AML should be aware of the HRQL impact of the disease and its treatment, in the long-term as well as the short-term. Researchers should evaluate the HRQL impact of new and investigational therapies.

Section snippets

Objectives

Increasing attention is being devoted to quantifying the health-related quality of life (HRQL) impact of different types of cancer and their therapeutic alternatives. Acute myeloid leukemia (AML) is treated aggressively with such therapies as chemotherapy and bone marrow transplantation (BMT), which are thought to significantly affect patient HRQL. Therefore, the goal of this study was to systematically assess and summarize what is known about the HRQL impact on patients of AML and its

Methods

This review process began with a systematic, electronically assisted search of English-language articles published by the international scientific community between 1990 and 2002. To maximize the sensitivity of the initial search, thereby promoting rapid and efficient identification of all potentially relevant articles, the initial search was conducted upon the MEDLINE database using the following broad Medical Subject Headings [MESH] and “text only” search terms: “acute myeloid leukemia” or

Results

The survey identified 21 articles that warranted review, 19 of which have been published in the past decade, since 1993.[1], [2], [3], [4], [5], [6], [7], [8], [9], [10], [11], [12], [13], [14], [15], [16], [17], [18], [19], [20], [21] The majority of the 21 have been published since 1997 (inclusive), although the oldest article was published in 1989.10

Conclusion

AML and the intensive treatment (e.g., chemotherapy, BMT, SCT) required to cure a patient with AML have a substantial negative impact on patient HRQL that has been measured by several different generic, cancer-specific and leukemia-specific instruments. The most negative HRQL burden is apparent after the diagnosis of the disease and during the course of the therapy. However, long-term survivors appear to recover almost completely as evidenced by scores in physical, psychological and emotional

References (21)

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