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The impact of maintenance therapy on sleep-wake rhythms and cancer-related fatigue in pediatric acute lymphoblastic leukemia

PURPOSE: To assess the impact of maintenance therapy and the additional impact of dexamethasone treatment on cancer-related fatigue and sleep-wake rhythms in pediatric acute lymphoblastic leukemia (ALL) patients and to determine the association between these outcomes. METHODS: A national cohort of p...

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Autores principales: Steur, L. M. H., Kaspers, G. J. L., van Someren, E. J. W., van Eijkelenburg, N. K. A., van der Sluis, I. M., Dors, N., van den Bos, C., Tissing, W. J. E., Grootenhuis, M. A., van Litsenburg, R. R. L.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7686190/
https://www.ncbi.nlm.nih.gov/pubmed/32285260
http://dx.doi.org/10.1007/s00520-020-05444-7
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author Steur, L. M. H.
Kaspers, G. J. L.
van Someren, E. J. W.
van Eijkelenburg, N. K. A.
van der Sluis, I. M.
Dors, N.
van den Bos, C.
Tissing, W. J. E.
Grootenhuis, M. A.
van Litsenburg, R. R. L.
author_facet Steur, L. M. H.
Kaspers, G. J. L.
van Someren, E. J. W.
van Eijkelenburg, N. K. A.
van der Sluis, I. M.
Dors, N.
van den Bos, C.
Tissing, W. J. E.
Grootenhuis, M. A.
van Litsenburg, R. R. L.
author_sort Steur, L. M. H.
collection PubMed
description PURPOSE: To assess the impact of maintenance therapy and the additional impact of dexamethasone treatment on cancer-related fatigue and sleep-wake rhythms in pediatric acute lymphoblastic leukemia (ALL) patients and to determine the association between these outcomes. METHODS: A national cohort of pediatric ALL patients (≥ 2 years) was included (± 1 year post-diagnosis). Patients receiving dexamethasone were assessed twice (assessment with and without dexamethasone). Actigraphy assessments were used to calculate sleep-wake outcomes with nonparametric methods. Cancer-related fatigue was assessed with the PedsQL Multidimensional Fatigue Scale. Sleep-wake rhythms and cancer-related fatigue were compared between patients participating in the assessment without dexamethasone and healthy children (linear regression) and between assessments with and without dexamethasone (mixed models). Using linear regression, associations between sleep-wake outcomes and cancer-related fatigue were determined during assessments with and without dexamethasone. RESULTS: Responses were collected for 125 patients (113 assessments with and 81 without dexamethasone). The sleep-wake rhythm was less stable (p = 0.03) and less robust (p = 0.01), with lower physical activity levels (p < 0.001) and higher cancer-related fatigue levels (p < 0.001) in ALL patients compared to healthy children. Physical activity was lower (p = 0.001) and cancer-related fatigue more severe (p ≤ 0.001) during assessments with dexamethasone compared to without dexamethasone. Sleep-wake outcomes were significantly associated with cancer-related fatigue during periods without dexamethasone, but not during periods with dexamethasone. CONCLUSION: Sleep-wake rhythms are disturbed, physical activity levels lower, and cancer-related fatigue levels higher during maintenance therapy. Interventions aimed to enhance sleep-wake rhythms during maintenance therapy could improve cancer-related fatigue. Families should be supported in coping with the additional burden of dexamethasone treatment to improve well-being of ALL patients. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s00520-020-05444-7) contains supplementary material, which is available to authorized users.
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spelling pubmed-76861902020-11-30 The impact of maintenance therapy on sleep-wake rhythms and cancer-related fatigue in pediatric acute lymphoblastic leukemia Steur, L. M. H. Kaspers, G. J. L. van Someren, E. J. W. van Eijkelenburg, N. K. A. van der Sluis, I. M. Dors, N. van den Bos, C. Tissing, W. J. E. Grootenhuis, M. A. van Litsenburg, R. R. L. Support Care Cancer Original Article PURPOSE: To assess the impact of maintenance therapy and the additional impact of dexamethasone treatment on cancer-related fatigue and sleep-wake rhythms in pediatric acute lymphoblastic leukemia (ALL) patients and to determine the association between these outcomes. METHODS: A national cohort of pediatric ALL patients (≥ 2 years) was included (± 1 year post-diagnosis). Patients receiving dexamethasone were assessed twice (assessment with and without dexamethasone). Actigraphy assessments were used to calculate sleep-wake outcomes with nonparametric methods. Cancer-related fatigue was assessed with the PedsQL Multidimensional Fatigue Scale. Sleep-wake rhythms and cancer-related fatigue were compared between patients participating in the assessment without dexamethasone and healthy children (linear regression) and between assessments with and without dexamethasone (mixed models). Using linear regression, associations between sleep-wake outcomes and cancer-related fatigue were determined during assessments with and without dexamethasone. RESULTS: Responses were collected for 125 patients (113 assessments with and 81 without dexamethasone). The sleep-wake rhythm was less stable (p = 0.03) and less robust (p = 0.01), with lower physical activity levels (p < 0.001) and higher cancer-related fatigue levels (p < 0.001) in ALL patients compared to healthy children. Physical activity was lower (p = 0.001) and cancer-related fatigue more severe (p ≤ 0.001) during assessments with dexamethasone compared to without dexamethasone. Sleep-wake outcomes were significantly associated with cancer-related fatigue during periods without dexamethasone, but not during periods with dexamethasone. CONCLUSION: Sleep-wake rhythms are disturbed, physical activity levels lower, and cancer-related fatigue levels higher during maintenance therapy. Interventions aimed to enhance sleep-wake rhythms during maintenance therapy could improve cancer-related fatigue. Families should be supported in coping with the additional burden of dexamethasone treatment to improve well-being of ALL patients. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s00520-020-05444-7) contains supplementary material, which is available to authorized users. Springer Berlin Heidelberg 2020-04-13 2020 /pmc/articles/PMC7686190/ /pubmed/32285260 http://dx.doi.org/10.1007/s00520-020-05444-7 Text en © The Author(s) 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
spellingShingle Original Article
Steur, L. M. H.
Kaspers, G. J. L.
van Someren, E. J. W.
van Eijkelenburg, N. K. A.
van der Sluis, I. M.
Dors, N.
van den Bos, C.
Tissing, W. J. E.
Grootenhuis, M. A.
van Litsenburg, R. R. L.
The impact of maintenance therapy on sleep-wake rhythms and cancer-related fatigue in pediatric acute lymphoblastic leukemia
title The impact of maintenance therapy on sleep-wake rhythms and cancer-related fatigue in pediatric acute lymphoblastic leukemia
title_full The impact of maintenance therapy on sleep-wake rhythms and cancer-related fatigue in pediatric acute lymphoblastic leukemia
title_fullStr The impact of maintenance therapy on sleep-wake rhythms and cancer-related fatigue in pediatric acute lymphoblastic leukemia
title_full_unstemmed The impact of maintenance therapy on sleep-wake rhythms and cancer-related fatigue in pediatric acute lymphoblastic leukemia
title_short The impact of maintenance therapy on sleep-wake rhythms and cancer-related fatigue in pediatric acute lymphoblastic leukemia
title_sort impact of maintenance therapy on sleep-wake rhythms and cancer-related fatigue in pediatric acute lymphoblastic leukemia
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7686190/
https://www.ncbi.nlm.nih.gov/pubmed/32285260
http://dx.doi.org/10.1007/s00520-020-05444-7
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