Paediatric relapsed acute leukaemia: curative intent chemotherapy improves quality of life

Area of Science:

• Pediatric Oncology
• Quality of Life Research
• Clinical Decision Making

Background:

• Pediatric patients with relapsed or induction failure acute leukemia face poor prognoses.
• Quality of Life (QoL) is a critical factor in treatment decisions for these children.
• Understanding the impact of treatment intent on QoL is essential for guiding care.

Purpose of the Study:

• To compare the effects of curative versus palliative treatment intent on child's physical health, pain, and fatigue.
• To assess the impact of treatment intent on parents' Quality of Life (QoL) over time.
• To evaluate these outcomes in pediatric leukemia patients experiencing relapse or induction failure in El Salvador.

Main Methods:

• Prospective observational cohort study involving children aged 2-18 years with acute leukemia at first relapse or induction failure.
• Data collected every 2 months for up to 2 years using validated proxy and self-report scales.
• Initial treatment intent (curative or palliative) categorized by physicians; QoL analyzed using linear mixed effects models.

Main Results:

• Initial curative intent was associated with significant improvements in the child's physical health, pain, and fatigue compared to palliative intent.
• No significant difference was observed in parents' QoL between the curative and palliative intent groups.
• Of 60 families enrolled, 44 children died during the 2-year observation period.

Conclusions:

• Curative intent treatment plans for pediatric acute leukemia patients with relapse or induction failure are linked to better physical health, pain management, and reduced fatigue.
• A curative approach can be a viable option for these patients, even when the prognosis is poor.
• Findings support considering curative intent to enhance patient well-being despite challenging diagnoses.