Hemoglobin (HB) Response and Improvements in Quality of Life (QOL) in Anemic Children With Cancer Receiving Myelosuppressive Chemotherapy (MCT)

2.50
Hdl Handle:
http://hdl.handle.net/10755/165335
Category:
Abstract
Type:
Presentation
Title:
Hemoglobin (HB) Response and Improvements in Quality of Life (QOL) in Anemic Children With Cancer Receiving Myelosuppressive Chemotherapy (MCT)
Author(s):
Hinds, P.; Hockenberry, M.; Feusner, J.; Horde, J.; Rackoff, W.; Razzouk, B.
Author Details:
P. Hinds, St. Jude Children's Research Hospital, Memphis, Tennessee, USA; M. Hockenberry; J. Feusner; J. Horde; W. Rackoff; B. Razzouk
Abstract:
Oncology nurses who treat children with cancer are involved with aspects of patient care related to QOL during MCT. CT-induced anemia, which impacts QOL in adults with cancer, is prevalent in these children. Purpose: In a randomized, double-blind study of children (5-18 yrs) with cancer and anemia receiving MCT, epoetin alfa (EPO) increased Hb but provided no benefit overall for the primary endpoint, self-reported QOL using the Pediatric Quality of Life Inventory (PedsQL-I) (Proc ASCO. 2004;23:abstract 8527). This post-hoc analysis of data from that study examined whether a difference in QOL was observed in children who were Hb responders (greater than/equal to 2-g/dL increase from baseline after Day 29). Theoretical/Scientific Framework: A randomized, placebo-controlled study was warranted to assess effects of IV EPO on QOL in children receiving MCT. Methods: Children receiving MCT for malignant solid tumors (ST), Hodgkin’s disease (HD), acute lymphocytic leukemia (ALL), or non-Hodgkin’s lymphoma (NHL) and anemic at study entry (Hb <12 g/dL for boys >12 yrs, <11 g/dL for girls >12 yrs, <10.5 g/dL for children 5-12 yrs) were stratified by tumor type (ST/HD or ALL/NHL) and randomized 1:1 to receive EPO 600 IU/kg or placebo IV weekly for 16 weeks. The dose was increased to 900 IU/kg weekly after 3-4 weeks if Hb increased <1 g/dL. QOL was assessed at baseline, Weeks 4/5, 9/10, 13, and 16. Data Analysis: Mean change from baseline to study end for PedsQL-I and Hb response was calculated for all patients with data after Day 29. P values were calculated using paired t-test. Repeated-measures analysis was performed taking into account QOL collected at multiple study visits. Findings and Implications: For this QOL analysis, 94 EPO and 86 placebo patients (of 222 enrolled) had data available. Hb responders had significant QOL improvements from baseline at study end (EPO, 11.3±20.7; placebo, 9.7±13.3; P<.001 for both treatment arms) versus nonresponders (EPO, 1.8±16.0; placebo, 3.6±15.9). Results from repeated-measures analysis confirmed these findings (P<.0001 for Hb responders). Further studies are warranted to optimize Hb response, QOL, and long-term outcomes with EPO in these children.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2005
Conference Name:
30th Annual Oncology Nursing Society Congress
Conference Host:
Oncology Nursing Society
Conference Location:
Orlando, Florida, USA
Sponsors:
Funding Sources: This study was supported by Ortho Biotech Clinical Affairs, LLC.
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titleHemoglobin (HB) Response and Improvements in Quality of Life (QOL) in Anemic Children With Cancer Receiving Myelosuppressive Chemotherapy (MCT)en_GB
dc.contributor.authorHinds, P.en_US
dc.contributor.authorHockenberry, M.en_US
dc.contributor.authorFeusner, J.en_US
dc.contributor.authorHorde, J.en_US
dc.contributor.authorRackoff, W.en_US
dc.contributor.authorRazzouk, B.en_US
dc.author.detailsP. Hinds, St. Jude Children's Research Hospital, Memphis, Tennessee, USA; M. Hockenberry; J. Feusner; J. Horde; W. Rackoff; B. Razzouken_US
dc.identifier.urihttp://hdl.handle.net/10755/165335-
dc.description.abstractOncology nurses who treat children with cancer are involved with aspects of patient care related to QOL during MCT. CT-induced anemia, which impacts QOL in adults with cancer, is prevalent in these children. Purpose: In a randomized, double-blind study of children (5-18 yrs) with cancer and anemia receiving MCT, epoetin alfa (EPO) increased Hb but provided no benefit overall for the primary endpoint, self-reported QOL using the Pediatric Quality of Life Inventory (PedsQL-I) (Proc ASCO. 2004;23:abstract 8527). This post-hoc analysis of data from that study examined whether a difference in QOL was observed in children who were Hb responders (greater than/equal to 2-g/dL increase from baseline after Day 29). Theoretical/Scientific Framework: A randomized, placebo-controlled study was warranted to assess effects of IV EPO on QOL in children receiving MCT. Methods: Children receiving MCT for malignant solid tumors (ST), Hodgkin&rsquo;s disease (HD), acute lymphocytic leukemia (ALL), or non-Hodgkin&rsquo;s lymphoma (NHL) and anemic at study entry (Hb &lt;12 g/dL for boys &gt;12 yrs, &lt;11 g/dL for girls &gt;12 yrs, &lt;10.5 g/dL for children 5-12 yrs) were stratified by tumor type (ST/HD or ALL/NHL) and randomized 1:1 to receive EPO 600 IU/kg or placebo IV weekly for 16 weeks. The dose was increased to 900 IU/kg weekly after 3-4 weeks if Hb increased &lt;1 g/dL. QOL was assessed at baseline, Weeks 4/5, 9/10, 13, and 16. Data Analysis: Mean change from baseline to study end for PedsQL-I and Hb response was calculated for all patients with data after Day 29. P values were calculated using paired t-test. Repeated-measures analysis was performed taking into account QOL collected at multiple study visits. Findings and Implications: For this QOL analysis, 94 EPO and 86 placebo patients (of 222 enrolled) had data available. Hb responders had significant QOL improvements from baseline at study end (EPO, 11.3&plusmn;20.7; placebo, 9.7&plusmn;13.3; P&lt;.001 for both treatment arms) versus nonresponders (EPO, 1.8&plusmn;16.0; placebo, 3.6&plusmn;15.9). Results from repeated-measures analysis confirmed these findings (P&lt;.0001 for Hb responders). Further studies are warranted to optimize Hb response, QOL, and long-term outcomes with EPO in these children.en_GB
dc.date.available2011-10-27T12:16:42Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T12:16:42Z-
dc.conference.date2005en_US
dc.conference.name30th Annual Oncology Nursing Society Congressen_US
dc.conference.hostOncology Nursing Societyen_US
dc.conference.locationOrlando, Florida, USAen_US
dc.description.sponsorshipFunding Sources: This study was supported by Ortho Biotech Clinical Affairs, LLC.-
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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