Publication Date
1-1-2020
Journal
Journal of Pediatric Oncology Nursing
DOI
10.1177/1043454220909785
PMID
32141369
PMCID
PMC7312345
PubMedCentral® Posted Date
3-6-2020
PubMedCentral® Full Text Version
Post-print
Published Open-Access
yes
Keywords
Adolescent, Biomarkers, Child, Child, Preschool, Cognition, Fatigue, Female, Humans, Longitudinal Studies, Male, Nausea, Oncology Nursing, Oxidative Stress, Pain, Precursor Cell Lymphoblastic Leukemia-Lymphoma, Sleep Wake Disorders, Syndrome, cognitive functioning, biomarkers, leukemia, symptom cluster
Abstract
Background: During treatment for acute lymphoblastic leukemia (ALL), children report co-occurring symptoms of fatigue, sleep disturbance, pain, nausea, and depression as a symptom cluster. Central nervous system–directed ALL therapies also put children at risk for cognitive impairments. Cancer therapies can cause an increase in oxidative stress, which may contribute to treatment-related symptoms. This study examined the longitudinal relationships between biomarkers of oxidative stress in the cerebrospinal fluid, the Childhood Cancer Symptom Cluster–Leukemia (CCSC-L), and cognition, in children over the first year of ALL treatment. Methods: Glutathione (GSH) biomarkers of oxidative stress were measured in cerebrospinal fluid collected during treatment lumbar punctures. GSH biomarkers, symptoms, and cognitive function of 132 children aged 3 to 18 years were evaluated at four time points during the first year of leukemia treatment. Participants, 7 years and older, completed self-report measures, and parents reported for younger children. Cognitive function measurements for all participants were completed by parents. A longitudinal parallel-process model was used to explore the influence of the initial measurement and the subsequent change over four time points of the GSH biomarkers on the CCSC-L and cognition. Results: GSH biomarkers increased over the four time points indicating decreasing oxidative stress. When GSH biomarkers were higher (less oxidative stress) at the initial measurement, the CCSC-L severity was lower, cognition was better, and cognition improved over the four measurements. Screening children for high levels of oxidative stress would be a foundation for future intervention studies to address symptom distress and cognitive impairments.
Included in
Cognition and Perception Commons, Cognitive Psychology Commons, Hematology Commons, Hemic and Lymphatic Diseases Commons, Medical Sciences Commons, Mental and Social Health Commons, Oncology Commons
