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IDENTIFYING FACTORS ASSOCIATED WITH VARIATIONS IN QUALITY OF LIFE FOR PATIENTS WITH DIFFERENT ACUTE LEUKEMIA TYPES: A GLOBAL SURVEY
Author(s): ,
Zack Pemberton-Whiteley
Affiliations:
Acute Leukemia Advocates Network,Bern,Switzerland
,
Jan Geissler
Affiliations:
Acute Leukemia Advocates Network,Bern,Switzerland
,
Sophie Wintrich
Affiliations:
Acute Leukemia Advocates Network,Bern,Switzerland
,
Rita O. Christensen
Affiliations:
Acute Leukemia Advocates Network,Bern,Switzerland
,
Bregje Verhoeven
Affiliations:
Acute Leukemia Advocates Network,Bern,Switzerland
,
Samantha Nier
Affiliations:
Acute Leukemia Advocates Network,Bern,Switzerland
,
Esther Oliva
Affiliations:
HM-PRO,Hatfield,United Kingdom
,
Sam Salek
Affiliations:
HM-PRO,Hatfield,United Kingdom
,
Tatyana Ionova
Affiliations:
HM-PRO,Hatfield,United Kingdom
,
Anne Rosemary Tate
Affiliations:
Quality Health,Chesterfield,United Kingdom
Jennie Bradley
Affiliations:
Quality Health,Chesterfield,United Kingdom
(Abstract release date: 05/14/20) EHA Library. Pemberton-Whiteley Z. 06/12/20; 294246; EP1766
Zack Pemberton-Whiteley
Zack Pemberton-Whiteley
Contributions
Abstract

Abstract: EP1766

Type: e-Poster

Background
The Acute Leukemia Advocates Network (ALAN) conducted a multi-country survey to gather information on the experiences, quality of life (QoL) and symptoms of adults (16+) with three different types of acute leukemia [acute myeloid leukemia (AML), acute lymphoblastic leukemia (ALL) and acute promyelocytic leukemia (APL)].

Aims
To examine if differences in QoL and symptom burden (measured by HM-PRO scores) are observed according to disease state and whether patients with worse experiences had a worse QoL.

Methods
This survey comprised 99 items, designed from a literature review of QoL and acute leukemia followed by input from clinical and patient advocacy experts. The study material was translated (9 languages) and promoted via patient advocacy groups from March 1, 2019 to November 29, 2019.

HM-PRO, an instrument designed to measure patient-reported outcomes in those with hematological malignancies, was incorporated into the study for assessing QoL and symptoms. This consists of: Part A (impact/QoL); and Part B (signs and symptoms). A higher score in each part represents greater (negative) impact on QoL and symptom burden.

Question 9 of the survey provides a measure for disease state: undergoing treatment, in remission following treatment or relapsed following treatment.

It was predicted that patients with a worse experience in each of the following areas would report a worse overall QoL: physical symptoms and side effects (Q13), emotional impact (Q14), physical and mental health (Q15), information from healthcare professionals (Q16), ability to perform meaningful activities (Q17) and well-being of carers, friends and family (Q18).

Spearman correlation analysis was used to determine the direction and strength of relationships between the measures. Wilcoxon rank-sum, Chi-squared and Kruskal-Wallis rank test were used to examine the differences between groups.

Results
There were 552 respondents: AML (332), ALL (132) and APL (81). Of these 222 were men, 327 female and 3 provided no gender. The results suggest that there is no overall significant difference in Part A (p=0.55) or Part B (p=0.23) of the HM-PRO scores between different acute leukemia types, though there were differences in demographic factors.

Patients in remission had significantly different scores for both Part A and Part B than those relapsed or undergoing treatment (p < 0.001). There was no significant difference between relapsed and treatment group for Part A scores (p=0.195), whereas Part B scores were significantly higher in relapsed patients than treatment (p=0.046). The different leukemia types showed similar distributions as above for part A and Part B according to disease status as shown in Figures 1 and 2.

The results confirmed our prediction that those with worse scores for Q13-Q18 have a worse QoL (higher HM-PRO score). The correlations (negative) were all statistically significant (p<0.05), suggesting that low HM-PRO scores are associated with good experiences and vice versa. Some individual questions were highly correlated (r=≥0.7) with one another (e.g. Q14 and Q13, or Q17 and Q18).

Conclusion
The results confirm there are differences in QoL and symptoms (as measured by HM-PRO) in acute leukemia patients in remission following treatment, compared to undergoing treatment and relapse. Patients with worse reported experience (Q13-18) have worse HM-PRO scores, suggesting that improving support in these areas may enhance overall QoL.

Session topic: 35. Quality of life, palliative & supportive care, ethics and health economics

Keyword(s): Acute leukemia, Patient, Quality of life

Abstract: EP1766

Type: e-Poster

Background
The Acute Leukemia Advocates Network (ALAN) conducted a multi-country survey to gather information on the experiences, quality of life (QoL) and symptoms of adults (16+) with three different types of acute leukemia [acute myeloid leukemia (AML), acute lymphoblastic leukemia (ALL) and acute promyelocytic leukemia (APL)].

Aims
To examine if differences in QoL and symptom burden (measured by HM-PRO scores) are observed according to disease state and whether patients with worse experiences had a worse QoL.

Methods
This survey comprised 99 items, designed from a literature review of QoL and acute leukemia followed by input from clinical and patient advocacy experts. The study material was translated (9 languages) and promoted via patient advocacy groups from March 1, 2019 to November 29, 2019.

HM-PRO, an instrument designed to measure patient-reported outcomes in those with hematological malignancies, was incorporated into the study for assessing QoL and symptoms. This consists of: Part A (impact/QoL); and Part B (signs and symptoms). A higher score in each part represents greater (negative) impact on QoL and symptom burden.

Question 9 of the survey provides a measure for disease state: undergoing treatment, in remission following treatment or relapsed following treatment.

It was predicted that patients with a worse experience in each of the following areas would report a worse overall QoL: physical symptoms and side effects (Q13), emotional impact (Q14), physical and mental health (Q15), information from healthcare professionals (Q16), ability to perform meaningful activities (Q17) and well-being of carers, friends and family (Q18).

Spearman correlation analysis was used to determine the direction and strength of relationships between the measures. Wilcoxon rank-sum, Chi-squared and Kruskal-Wallis rank test were used to examine the differences between groups.

Results
There were 552 respondents: AML (332), ALL (132) and APL (81). Of these 222 were men, 327 female and 3 provided no gender. The results suggest that there is no overall significant difference in Part A (p=0.55) or Part B (p=0.23) of the HM-PRO scores between different acute leukemia types, though there were differences in demographic factors.

Patients in remission had significantly different scores for both Part A and Part B than those relapsed or undergoing treatment (p < 0.001). There was no significant difference between relapsed and treatment group for Part A scores (p=0.195), whereas Part B scores were significantly higher in relapsed patients than treatment (p=0.046). The different leukemia types showed similar distributions as above for part A and Part B according to disease status as shown in Figures 1 and 2.

The results confirmed our prediction that those with worse scores for Q13-Q18 have a worse QoL (higher HM-PRO score). The correlations (negative) were all statistically significant (p<0.05), suggesting that low HM-PRO scores are associated with good experiences and vice versa. Some individual questions were highly correlated (r=≥0.7) with one another (e.g. Q14 and Q13, or Q17 and Q18).

Conclusion
The results confirm there are differences in QoL and symptoms (as measured by HM-PRO) in acute leukemia patients in remission following treatment, compared to undergoing treatment and relapse. Patients with worse reported experience (Q13-18) have worse HM-PRO scores, suggesting that improving support in these areas may enhance overall QoL.

Session topic: 35. Quality of life, palliative & supportive care, ethics and health economics

Keyword(s): Acute leukemia, Patient, Quality of life

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