Many survivors of acute myeloid leukemia (AML) recover in terms of quality of life (QOL) and fatigue after 3 years, but may not return to previous levels of physical performance, according to a study published in Leukemia.
Although evidence from a previous 1-year analysis of the current study revealed that patients with AML recover significantly in terms of QOL, fatigue, and physical functioning after intensive chemotherapy (IC), the improvements in fatigue and physical function were marginal; long-term evaluations of these patients are needed.
For this prospective, longitudinal study, researchers enrolled 237 adult patients with newly diagnosed AML undergoing IC without stem-cell transplant. Patients were instructed to complete assessments of QOL and physical function at baseline (pre-IC), and at 11 time points over the next 3 years. QOL was assessed using the European Organisation for the Research and Treatment of Cancer 30-item questionnaire (EORTC QLQ-C30), and fatigue was assessed with the Functional Assessment of Cancer Therapy Fatigue subscale (FACT-F). Physical function was assessed using the 6 minute walk test (6MWT), grip strength, and chair stands.
After 3 years, 59 patients remained on study and in complete remission, and were evaluable for analysis.
Results showed that after 3-years of follow-up, patients experienced significant recovery for QOL and fatigue. Global QOL recovery was observed among 79%, 75%, and 86% of patients after years 1, 2, and 3 respectively. The QLQ-C30 subscales with the greatest recovery were physical and emotional functioning.
FACT-F scores showed that 68% of patients recovered by year 1, and this increased to 77% after 3 years.
Physical performance however, had low rates of recovery. Only 17% of patients recovered to baseline levels of 6MWT and 42% returned to normal grip strength after 3 years.
The vast majority of patients eventually experience significant recovery in global QOL as well as fatigue, but the authors concluded “recovery in objective physical function remained blunted and suggests the need for physical rehabilitation.”
Timilshina N, Breunis H, Tomlinson GA, et al. Long-term recovery of quality of life and physical function over three years in adult survivors of acute myeloid leukemia after intensive chemotherapy [published online June 8, 2018]. Leukemia. doi: 10.1038/s41375-018-0162-5