Neha Kayastha1, Steven P Wolf2,3, Susan C Locke2, Gregory P Samsa2,3, Areej El-Jawahri4, Thomas W LeBlanc5,6,7. 1. Duke University School of Medicine, Box: DUMC 2927, Durham, NC, 27703, USA. 2. Duke Cancer Institute, Box: DUMC 2715, Durham, NC, 27710, USA. 3. Department of Biostatistics and Bioinformatics, Duke University Medical Center, 2424 Erwin Road, Suite 1102 Hock Plaza Box 2721, Durham, NC, 27710, USA. 4. Department of Hematology and Oncology, Massachusetts General Hospital, 55 Fruit Street, Yawkey 9E, Boston, MA, 02114, USA. 5. Duke University School of Medicine, Box: DUMC 2927, Durham, NC, 27703, USA. thomas.leblanc@duke.edu. 6. Duke Cancer Institute, Box: DUMC 2715, Durham, NC, 27710, USA. thomas.leblanc@duke.edu. 7. Duke University School of Medicine, Box 2715, DUMC, Durham, NC, 27710, USA. thomas.leblanc@duke.edu.
Abstract
PURPOSE: Shared decision-making in acute myeloid leukemia (AML) requires understanding patients' longitudinal experiences of illness, but little is known about the impact of remission status on patient-reported outcomes (PROs). We aimed to explore the association between remission status and PROs 6-12 months following induction chemotherapy. METHODS: Forty-two patients completed three validated instruments characterizing symptom burden (Patient Care Monitor v2.0), distress (NCCN Distress Thermometer), and QOL (FACT-Leu), as part of a longitudinal observational study. We used regression models to explore the relationship between remission status and PROs, and explore differences by initial disease type (de novo versus secondary/relapsed AML). RESULTS: Those with secondary or relapsed AML at study onset had marked impairments in all measures compared to de novo AML patients. After 6 months, their mean distress score was 4.8 (> 4.0 warrants intervention), they reported a mean of 14.1 moderate/severe symptoms and had a mean QOL score of 113.6, compared to 1.0, 1.7, and 155.2, respectively, for those with de novo AML (p < .0001). Similarly, patients in relapse had a mean distress score of 5.3, a mean of 12.8 moderate/severe symptoms, and a mean QOL score of 113.4, compared to 1.8, 5.7, and 143.8, respectively, among those in remission (p < .005). These patterns persisted after adjusting for baseline differences (p < .0001). CONCLUSION: Remission is associated with markedly better patient well-being in AML. Patients with secondary or relapsed AML face more severe symptom burden, distress, and QOL issues after induction. Interventions are needed to improve AML patients' experiences of illness.
PURPOSE: Shared decision-making in acute myeloid leukemia (AML) requires understanding patients' longitudinal experiences of illness, but little is known about the impact of remission status on patient-reported outcomes (PROs). We aimed to explore the association between remission status and PROs 6-12 months following induction chemotherapy. METHODS: Forty-two patients completed three validated instruments characterizing symptom burden (Patient Care Monitor v2.0), distress (NCCN Distress Thermometer), and QOL (FACT-Leu), as part of a longitudinal observational study. We used regression models to explore the relationship between remission status and PROs, and explore differences by initial disease type (de novo versus secondary/relapsed AML). RESULTS: Those with secondary or relapsed AML at study onset had marked impairments in all measures compared to de novo AMLpatients. After 6 months, their mean distress score was 4.8 (> 4.0 warrants intervention), they reported a mean of 14.1 moderate/severe symptoms and had a mean QOL score of 113.6, compared to 1.0, 1.7, and 155.2, respectively, for those with de novo AML (p < .0001). Similarly, patients in relapse had a mean distress score of 5.3, a mean of 12.8 moderate/severe symptoms, and a mean QOL score of 113.4, compared to 1.8, 5.7, and 143.8, respectively, among those in remission (p < .005). These patterns persisted after adjusting for baseline differences (p < .0001). CONCLUSION: Remission is associated with markedly better patient well-being in AML. Patients with secondary or relapsed AML face more severe symptom burden, distress, and QOL issues after induction. Interventions are needed to improve AMLpatients' experiences of illness.
Authors: Amy P Abernethy; Syed Yousuf Zafar; Hope Uronis; Jane L Wheeler; April Coan; Krista Rowe; Rebecca A Shelby; Robin Fowler; James E Herndon Journal: J Pain Symptom Manage Date: 2010-06-25 Impact factor: 3.612
Authors: Thomas W LeBlanc; Laura J Fish; Catherine T Bloom; Areej El-Jawahri; Debra M Davis; Susan C Locke; Karen E Steinhauser; Kathryn I Pollak Journal: Psychooncology Date: 2016-12-19 Impact factor: 3.894
Authors: M A Sekeres; R M Stone; D Zahrieh; D Neuberg; V Morrison; D J De Angelo; I Galinsky; S J Lee Journal: Leukemia Date: 2004-04 Impact factor: 11.528
Authors: Jeff P Sharman; Kim Cocks; Chadi Nabhan; Nicole Lamanna; Neil E Kay; David L Grinblatt; Christopher R Flowers; Matthew S Davids; Pavel Kiselev; Arlene S Swern; Kristen Sullivan; Mecide M Gharibo; E Dawn Flick; Andrew Trigg; Anthony Mato Journal: EJHaem Date: 2020-07-26
Authors: Hermioni L Amonoo; Monica H Bodd; Matthew J Reynolds; Ashley M Nelson; Richard Newcomb; Patrick Connor Johnson; Tejaswini M Dhawale; Rachel Plotke; Lauren Heuer; Sabah Gillani; Daniel Yang; Emma C Deary; Elizabeth Daskalakis; Lauren Goldschen; Andrew Brunner; Amir T Fathi; Thomas W LeBlanc; Areej El-Jawahri Journal: Blood Adv Date: 2022-04-12
Authors: Keith W Pratz; Panayiotis Panayiotidis; Christian Recher; Xudong Wei; Brian A Jonas; Pau Montesinos; Vladimir Ivanov; Andre C Schuh; Courtney D DiNardo; Jan Novak; Vlatko Pejsa; Don Stevens; Su-Peng Yeh; Inho Kim; Mehmet Turgut; Nicola Fracchiolla; Kazuhito Yamamoto; Yishai Ofran; Andrew H Wei; Cat N Bui; Katy Benjamin; Rajesh Kamalakar; Jalaja Potluri; Wellington Mendes; Jacob Devine; Walter Fiedler Journal: Blood Cancer J Date: 2022-04-20 Impact factor: 9.812