急性白血病患儿造血干细胞移植后的生存质量分析

Quality of life analysis of children with pediatric acute leukemia post hematopoietic stem cell transplantation

目的 评价急性白血病患儿在造血干细胞移植（HSCT）治疗后的生存质量;分析影响HSCT患儿生存质量的因素.方法 选取60例在北京2个血液中心接受HSCT治疗,移植成功并存活4个月以上的2～18岁的急性白血病患儿作为研究对象.患儿家长及8～18岁患儿完成PedsQLTM癌症模块3.0中文版,并从病例中收集患儿的临床资料,对患儿的生存质量进行测评、分析.结果 49例患儿家长及32例患儿参与并完成量表.49例患儿中男34例（69.4％）,女15例（30.6％）;年龄（9.94±4.24）岁;急性淋巴细胞白血病28例（57.1％）,急性髓细胞白血病19例（38.8％）,急性混合性白血病2例（4.1％）;复发后缓解患儿16例（32.7％）,首次缓解患儿33例（67.3％）.各年龄段患儿在HSCT 4个月后总体生存质量可达到中等偏上,平均分为68 ～ 75分（总分100分）;移植前状态（OR=0.197,P=0.021）及母亲文化程度（OR=3.932,P=0.043）是HSCT患儿生存质量的影响因素：移植前为复发后缓解或母亲文化程度低的患儿生存质量更差;性别、诊断、供者来源、轻度慢性移植物抗宿主病、父母亲工作情况、父亲文化程度、家庭所在区域对患儿生存质量的影响差异无统计学意义.结论 HSCT 4个月后患儿总体生存质量可达到中等偏上,影响HSCT患儿生存质量的因素包括HSCT前状态及母亲文化程度.

Objective To evaluate the quality of life of patients with pediatric acute leukemia post hematopoietic stem cell transplantation （HSCT） and to analyze the influential factors for patients＇ quality of life.Methods Sixty of acute leukemia patients from 2 to 18 years old received HSCT and attained more than 4 months survival were recruited from 2 hematology centers in Beijing.PedsQLTM Cancer Module 3.0 Chinese mandarin version was completed by both parents and 8-18 years old patients.Clinical data were extracted from medical records.The quality of life of patients was evaluated and analyzed.Results Forty-nine parents and 32 patients consented to participate and completed the questionnaires,with 34 boys （69.4%） and 15 girls （30.6%）.The age of them was （9.94-±4.24）years old.The sample included 28 acute lymphoblastic leukemia patients （57.1%）,19 acute myeloid leukemia patients （38.8%） and 2 acute mixed leukemia patients （4.1%）; 16 second complete remission patients （32.7%） and 33 first remission patients （67.3%）.The mean scores of overall quality of life after HSCT were 68-75 （out of 100）,which was above the average.The disease status before transplantation （OR =0.197,P =0.021） and the education level of patient＇s mother （OR =3.932,P =0.043） were the influential factors for children＇s quality of life post HSCT：second complete remission status and the lower education level of mother resulted in worse quality of life.Neither gender,diagnosis,donor sources,slight graft versus host disease,parents＇ job,education level of father,nor home area influenced the quality of life significantly.Conclusions The overall quality of life of HSCT patients is above the average.The influential factors for patients＇ quality of life include the disease status before transplantation and the educational level of patients＇ mother.