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

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.