Using Patient-Reported Outcomes Improves Symptoms in Adults With Acute Leukemia
Patients diagnosed with acute leukemia often require intensive chemotherapy and prolonged hospitalization. Worsening symptoms can lead to a decline in basic mobility and an increase in fall risk if left untreated.
Ashley Bryant, PhD, RN, OCN®, assistant professor at the University of North Carolina at Chapel Hill School of Nursing, was the recipient of the 2017 Victoria Mock New Investigator Award and gave a lecture at the 42nd Annual Congress in Denver, CO, on her work on patient-reported symptoms and quality of life. The award honors Victoria Mock, DNSc, RN, AOCN®, FAAN, and recognizes the contributions of new investigators in building a scientific foundation for oncology nursing practice.
The goal of her research was to determine how symptoms and function can be improved in adults with acute leukemia who are undergoing chemotherapy. She said including patient-reported outcomes (PROs) as a part of patient care is important to manage symptoms, improve quality of life, and impact patient satisfaction.
Bryant first shared details of a literature review of clinical trials using PRO instruments for myelodysplastic syndromes and acute myeloid leukemia ([AML]; still under review and will be published in Leukemia and Lymphoma), which identified 10 phase II and III studies that met all study criteria. European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-C30 was the most common PRO measure used. Fatigue, depression, and anxiety are common symptoms of concern in this patient population. Fatigue can have a negative impact on patient function, socialization, and quality of life.
Bryant’s EQUAL (Exercise and Quality of Life in Acute Leukemia Adults) trial (still under review and will be published in Integrative Cancer Therapies) assessed the outcomes of an exercise intervention for adults with acute leukemia (AML or acute lymphocytic leukemia) who were hospitalized. The intervention cohort (n = 8) engaged in a four-week exercise program, whereas a control cohort (n = 9) did not. The authors assessed demographic and clinical data, PROs, and blood samples.
Patients ranged from 28–69 years of age, a majority (64%) were male, and the median number of comorbidities was 1.5 (range = 0–5) in the intervention group and 2 (range = 0–9) in the control group. Common comorbidities were arthritis (82%), hypertension (68%), anxiety (58%), and depression (58%).
In the intervention cohort, aerobic and strength training exercises were performed four days per week in the morning and evening in 20- to 30-minute sessions. See Table 1 and Table 2 for outcomes.
This session was supported by the ONS Distinguished Nurse researcher fund within the ONS Foundation.