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A Comparison of Races and Leukemia Subtypes Among Patients in Different Cancer Survivorship Phases

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Abstract

Background

The three phases of cancer survivorship include the acute survival phase (ASP), the extended survival phase (ESP), and the permanent survival phase (PSP). This Institutional Review Board–approved retrospective pilot project compared races and leukemia subtypes among patients in the ASP, ESP, and PSP.

Methods

Fifty-five adult patients from our National Cancer Institute–designated cancer center were individually interviewed. Subjects were asked about multiple areas of survivorship including their social support system, distress level, and quality of life.

Results

Demographics of the 55 patients are acute lymphocytic leukemia (ALL), 10; acute myelocytic leukemia (AML), 9; chronic lymphocytic leukemia (CLL), 23; and chronic myelocytic leukemia (CML), 13. There were 23 females and 32 males, 30 Hispanics, 20 Caucasians, and 5 African-Americans. Twenty-two patients were in the ASP, 21 in the ESP, and 12 in the PSP. AML patients experienced the most physical, family, emotional, and spiritual problems (78%, 33%, 56%, and 22%, respectively). AML patients also had the highest distress level with a mean score of 5.8 (SD 1.7), compared to ALL (1.8), CLL (3.2), and CML (5.1) (P value < .001). Among all the phases of survivorship, the ASP had the highest distress level (mean, 4.8) and the worst quality of life (mean, 2.3). The ASP patients had the most treatment for depression (38%). When comparing races, African Americans and Hispanics (40% and 37%, respectively) were unable to cope with finances, compared to Caucasians (5%), (P value .016). Fear of recurrence was higher in Hispanics (67%), compared to African Americans (40%) and Caucasians (30%) (P value .031). Hispanics (40%) experienced more problems with housing, insurance, and work, as compared to African Americans (20%) and Caucasians (10%) (P value .047).

Conclusion

This study addresses the perceptions and beliefs of leukemia survivors and found that AML and minority patients need further investigation on various aspects of quality of life.

Introduction

There are three phases of cancer survivorship: acute, extended, and permanent survival phases. The acute survival phase (ASP) begins with diagnosis of the disease and is dominated by diagnostic and therapeutic efforts. Extended survival phase (ESP) occurs when a patient goes into remission or has completed treatment. The permanent survival phase (PSP) is equated with cure. Although fear and anxiety are known elements of the phases of cancer survivorship, other perceptions of patients during these phases are not well known.1, 2, 3, 4, 5 Although there has been a large research focus on survivorship in pediatrics, as well as solid tumor malignancies, this has been an understudied area among adults who have leukemia. Previous work by our group has focused on the ASP in solid tumors, as well as the perceptions of breast cancer patients during the ESP. 6, 7 This International Review Board–approved retrospective pilot project examined perceptions and beliefs among patients with leukemia in the ASP, ESP, and PSP.

Section snippets

Methods

Fifty-five adult patients from our National Cancer Institute–designated cancer center were individually interviewed by one interviewer. Questions were taken from the People Living With Cancer website, the National Comprehensive Cancer Network, and the National Research Council. 8, 9, 10 These 57 questions were beta tested in multiple iterations. Subjects were asked about multiple areas of survivorship including their social support system, satisfaction and compliance with treatment, and

Demographics

Ten of the patients had acute lymphocytic leukemia (ALL), 9 had acute myelocytic leukemia (AML), 23 had chronic lymphocytic leukemia (CLL), and 13 had chronic myelocytic leukemia (CML). There were 23 females and 32 males. The study included 55% Hispanics, 36% Caucasians, and 9% African-Americans. Twenty-two patients were in the ASP, 21 in the ESP, and 12 in the PSP (Table 1).

Overall

Overall, 90% of leukemia patients were satisfied with their treatment and 95% believed that they were well-informed about

Conclusions

This pilot study addresses the perceptions and beliefs of leukemia survivors. Although patients are satisfied in many areas in the PSP, there is still a need to further investigate various aspects of quality of life during the ASP and ESP, particularly in AML and minority patients. Future prospective studies are warranted that identify and overcome barriers to optimal cancer survivorship care.

Disclosures

The authors have stated that they have no conflicts of interest.

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