Symptom Trajectories in Children Receiving Treatment for Leukemia: A Latent Class Growth Analysis With Multitrajectory Modeling

Marilyn J. Hockenberry, Mary C. Hooke, Cheryl Rodgers, Olga Taylor, Kari M. Koerner, Pauline Mitby, Ida M Moore, Michael E. Scheurer, Wei Pan

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Context: Cancer treatment symptoms play a major role in determining the health of children with cancer. Symptom toxicity often results in complications, treatment delays, and therapy dose reductions that can compromise leukemia therapy and jeopardize chances for long-term survival. Critical to understanding symptom experiences during treatment is the need for exploration of "why" inter-individual symptom differences occur; this will determine who may be most susceptible to treatment toxicities. Objectives: This study examined specific symptom trajectories during the first 18 months of childhood leukemia treatment. Symptom measures included fatigue, sleep disturbances, pain, nausea, and depression. Methods: Symptom trajectories of 236 children with leukemia three to 18 years old were explored prospectively over four periods: initiation of post-induction therapy, four and eight post-induction therapy, and the last time point was at the beginning of maintenance/continuation therapy. Latent class growth analysis was used to classify patients into distinctive groups with similar symptom trajectories based on patients' response patterns on the symptom measures over time. Results: Three latent classes of symptom trajectories were identified and classified into mild, moderate, and severe symptom trajectories. The only demographic characteristic with a significant relationship to membership in the latent class symptom trajectories was race/ethnicity. All other demographic characteristics including leukemia risk levels showed no significant relationships. Conclusion: This study is unique in that groups of patients with similar symptoms were identified rather than groups of symptoms. Further research using latent class growth analysis is needed.

Original languageEnglish (US)
JournalJournal of Pain and Symptom Management
DOIs
StateAccepted/In press - 2017

Fingerprint

Leukemia
Growth
Therapeutics
Demography
Individuality
Nausea
Fatigue
Neoplasms
Sleep
Maintenance
Depression
Pain
Survival
Research

Keywords

  • Childhood leukemia
  • Latent class growth analysis
  • Leukemia therapy
  • Symptom trajectories
  • Treatment toxicities

ASJC Scopus subject areas

  • Nursing(all)
  • Clinical Neurology
  • Anesthesiology and Pain Medicine

Cite this

Symptom Trajectories in Children Receiving Treatment for Leukemia : A Latent Class Growth Analysis With Multitrajectory Modeling. / Hockenberry, Marilyn J.; Hooke, Mary C.; Rodgers, Cheryl; Taylor, Olga; Koerner, Kari M.; Mitby, Pauline; Moore, Ida M; Scheurer, Michael E.; Pan, Wei.

In: Journal of Pain and Symptom Management, 2017.

Research output: Contribution to journalArticle

Hockenberry, Marilyn J. ; Hooke, Mary C. ; Rodgers, Cheryl ; Taylor, Olga ; Koerner, Kari M. ; Mitby, Pauline ; Moore, Ida M ; Scheurer, Michael E. ; Pan, Wei. / Symptom Trajectories in Children Receiving Treatment for Leukemia : A Latent Class Growth Analysis With Multitrajectory Modeling. In: Journal of Pain and Symptom Management. 2017.
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abstract = "Context: Cancer treatment symptoms play a major role in determining the health of children with cancer. Symptom toxicity often results in complications, treatment delays, and therapy dose reductions that can compromise leukemia therapy and jeopardize chances for long-term survival. Critical to understanding symptom experiences during treatment is the need for exploration of {"}why{"} inter-individual symptom differences occur; this will determine who may be most susceptible to treatment toxicities. Objectives: This study examined specific symptom trajectories during the first 18 months of childhood leukemia treatment. Symptom measures included fatigue, sleep disturbances, pain, nausea, and depression. Methods: Symptom trajectories of 236 children with leukemia three to 18 years old were explored prospectively over four periods: initiation of post-induction therapy, four and eight post-induction therapy, and the last time point was at the beginning of maintenance/continuation therapy. Latent class growth analysis was used to classify patients into distinctive groups with similar symptom trajectories based on patients' response patterns on the symptom measures over time. Results: Three latent classes of symptom trajectories were identified and classified into mild, moderate, and severe symptom trajectories. The only demographic characteristic with a significant relationship to membership in the latent class symptom trajectories was race/ethnicity. All other demographic characteristics including leukemia risk levels showed no significant relationships. Conclusion: This study is unique in that groups of patients with similar symptoms were identified rather than groups of symptoms. Further research using latent class growth analysis is needed.",
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AB - Context: Cancer treatment symptoms play a major role in determining the health of children with cancer. Symptom toxicity often results in complications, treatment delays, and therapy dose reductions that can compromise leukemia therapy and jeopardize chances for long-term survival. Critical to understanding symptom experiences during treatment is the need for exploration of "why" inter-individual symptom differences occur; this will determine who may be most susceptible to treatment toxicities. Objectives: This study examined specific symptom trajectories during the first 18 months of childhood leukemia treatment. Symptom measures included fatigue, sleep disturbances, pain, nausea, and depression. Methods: Symptom trajectories of 236 children with leukemia three to 18 years old were explored prospectively over four periods: initiation of post-induction therapy, four and eight post-induction therapy, and the last time point was at the beginning of maintenance/continuation therapy. Latent class growth analysis was used to classify patients into distinctive groups with similar symptom trajectories based on patients' response patterns on the symptom measures over time. Results: Three latent classes of symptom trajectories were identified and classified into mild, moderate, and severe symptom trajectories. The only demographic characteristic with a significant relationship to membership in the latent class symptom trajectories was race/ethnicity. All other demographic characteristics including leukemia risk levels showed no significant relationships. Conclusion: This study is unique in that groups of patients with similar symptoms were identified rather than groups of symptoms. Further research using latent class growth analysis is needed.

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