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Long-Term Quality of Life in Patients With Acute Promyelocytic Leukemia

Completed
Conditions
Acute Promyelocytic Leukemia
Interventions
Other: Health Related Quality of Life (HRQOL) measures
Registration Number
NCT01910623
Lead Sponsor
Gruppo Italiano Malattie EMatologiche dell'Adulto
Brief Summary

This study will focus on acute promyelocytic leukemia patients who have been diagnosed more than 5 years ago and their present quality of life.

The possible late effects of cancer treatment can include several issues and, thus, there has been an increasing interest worldwide in studying the long-term impact of these in patients' life.

Detailed Description

This study will focus on long-term survivors as defined by the America Cancer Society, that is surviving the initial diagnosis for more than 5 years. Previous research has investigated long-term Health Related Quality of Life (HRQOL) in patients with acute myeloid leukemia, however, this will be the first research conducted to investigate long-term HRQOL outcomes in patients with acute promyelocytic leukemia (APL).

The potential late effects of cancer treatment can include second malignancies or other chronic conditions affecting physical and emotional well-being. Therefore, there has been an increasing interest worldwide in evaluating the longer-term impact of cancer and its treatment. Currently large cohort of patients enjoys disease-free survival of 5 years or longer. However, a disease-free status is not synonymous with a life free of physical and psychological health related to the cancer and/or its treatment. Research shows that cancer related health concerns persist long after initial treatment and this has been shown in several cancer populations including prostate, testicular, breast cancer and lymphoma patients. Long-term cancer survivors can experience treatment-induced morbidity (e.g. cardiovascular damage due to chemotherapy or radiotherapy; infertility and second tumors), chronic disease and treatment-related symptoms, functional impairment, psychosocial problems, and practical problems.

Since the introduction of the vitamin A derivative all-trans retinoic acid (ATRA) as front-line therapy for APL, the outcome of this acute leukemia subtype has changed from the state of a most frequently fatal leukemia to the condition of a highly curable disease. The Italian cooperative group GIMEMA designed in 1993 the AIDA (Atra plus IDArubicin) trial for newly diagnosed APL. Results on over 800 patients showed a complete remission (CR) rate \> 90% and an overall survival of 76% and confirmed that the concomitant administration of ATRA and chemotherapy is more effective than the sequential administration. Following the identification of distinct prognostic categories among APL patients, the GIMEMA group designed a new trial (AIDA2000) in which the intensity of post-remission treatment was adapted to the relapse risk and 498 patients were enrolled since January 2000. The results recently published showed a CR rate \>90% with molecular remission rate after third consolidation of 98%. The new schedule allowed a Disease Free Survival (DFS) of 86% and showed that a risk-adapted strategy including ATRA for consolidation provides an outcome improvement in newly diagnosed patients. As reported by an international panel of experts, simultaneous ATRA and anthracycline chemotherapy schedules such as those used in the AIDA protocols represent the state of the art therapy for newly diagnosed APL.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
Not specified
Inclusion Criteria
  • APL patients previously enrolled in the studies GIMEMA AIDA0493 and AIDA2000 surviving the initial diagnosis for more than 5 years and are in CR.
  • Written informed consent provided.
  • Adult patients at the time of registration onto this study.
Exclusion Criteria
  • Concomitant major psychiatric disorders or cognitive dysfunctions that would interfere with a self-reported evaluation.

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
Patients being studiedHealth Related Quality of Life (HRQOL) measuresAPL patients previously enrolled in GIMEMA AIDA 0493 and AIDA 2000 studies.
Primary Outcome Measures
NameTimeMethod
Clinical significance on each of the SF-36 questionnaire scales.One month from study entry.

This will be performed by using HRQOL scores available for the Italian population. This will help identify which specific areas are mostly impaired and to what extent these patients recover in terms of HRQOL over the long run. This kind of comparison, which is only possible when HRQOL cultural-based norms are available, is largely used when investigating long-term HRQOL in cancer survivors and it is widely recognized as one of the most valuable approach in this kind of research setting.

Secondary Outcome Measures
NameTimeMethod
Association of EORTC-QLQC30 scales with different treatment strategies tested in the two GIMEMA trials.One month from study entry.
Association of EORTC-QLQC30 scales with social-demographic and clinical treatment related variables.One month from study entry.
Possible differences in EORTC-QLQC30, MDASI and SF-36 scales between patients who were less than eighteen years old at the time of diagnosis and patients who were at least eighteen years old at the time of diagnosis.One month from study entry
Association of MDASI scales (i.e., symptom severity and symptom interference) with different treatment strategies tested in the two GIMEMA trials.One month from study entry.
Association of rate of secondary malignancies with different treatment strategies tested in the two GIMEMA trials.One month from study entry

Trial Locations

Locations (38)

Università degli Studi di Verona - A. O. - Istituti Ospitalieri di Verona- Div. di Ematologia - Policlinico G.B. Rossi

🇮🇹

Verona, Italy

N. Osp. divisione di Ematologia "S.Gerardo dei Tintori!"

🇮🇹

Monza, Italy

Divisione di Ematologia con trapianto di midollo - A.U. Policlinico "Paolo Giaccone"

🇮🇹

Palermo, Italy

Istituto di Ematologia "Lorenzo e A. Seragnoli" - Università degli Studi di Bologna - Policlinico S. Orsola - Malpighi

🇮🇹

Bologna, Italy

Azienda Sanitaria di Bolzano - Ospedale Centrale - Ematologia e Centro TMO

🇮🇹

Bolzano, Italy

Divisione di Ematologia Ospedale "Santa Maria Goretti"

🇮🇹

Latina, Italy

Ospedale Niguarda " Ca Granda"

🇮🇹

Milano, Italy

ASL N.8 - Ospedale "A. Businco" - Struttura Complessa di Ematologia e CTMO

🇮🇹

Cagliari, Italy

Azienda Ospedaliera Pugliese Ciaccio - Presidio Ospedaliero A.Pugliese - Unità Operativa di Ematologia

🇮🇹

Catanzaro, Italy

IRCCS_AOU San Martino-IST-Ematologia 1-Monoblocco 11°piano- lato ponente

🇮🇹

Genova, Italy

Cattedra di Ematologia CTMO Università degli Studi di Parma

🇮🇹

Parma, Italy

S.C. Ematologia - Fondazione IRCCS Policlinico S. Matteo

🇮🇹

Pavia, Italy

U.O. Ematologia Clinica - Azienda USL di Pescara

🇮🇹

Pescara, Italy

Az.Ospedaliera S.G.Moscati

🇮🇹

Avellino, Italy

Università di Catania - Cattedra di Ematologia - Ospedale "Ferrarotto"

🇮🇹

Catania, Italy

Clinica Ematologica - DiMI - Università degli Studi di Genova

🇮🇹

Genova, Italy

Azienda Ospedaliera Universitaria - Università degli Studi di Napoli "Federico II" - Facoltà di Medicina e Chirurgia

🇮🇹

Napoli, Italy

UO Ematologia con trapianto-Università degli Studi di Bari Aldo Moro

🇮🇹

Bari, Italy

Divisione di Ematologia - Ospedali Riuniti

🇮🇹

Bergamo, Italy

Spedali Civili - Brescia - Azienda Ospedaliera - U.O. Ematologia

🇮🇹

Brescia, Italy

Policlinico di Careggi

🇮🇹

Firenze, Italy

Servizio Sanitario Nazionale - Azienda Ospedaliera di Rilievo Nazionale "A. Cardarelli" - Struttura Complessa di Ematologia - Div. TERE- 4° piano - Padiglione Palermo

🇮🇹

Napoli, Italy

Calabria Dipartimento Emato-Oncologia A.O."Bianchi-Melacrino-Morelli"

🇮🇹

Reggio Calabria, Italy

Unità Operativa Complessa di Ematologia - Arcispedale S. Maria Nuova

🇮🇹

Reggio Emilia, Italy

SCDO Ematologia 2 AOU S.Giovanni Battista

🇮🇹

Torino, Italy

Ospedali Riuniti "Villa Sofia-Cervello"

🇮🇹

Palermo, Italy

Centro Oncologico Modenese - Dipartimento di Oncoematologia

🇮🇹

Modena, Italy

Sezione di Ematologia ed Immunologia Clinica - Ospedale S.Maria della Misericordia

🇮🇹

Perugia, Italy

U.O.C. Ematologia - Ospedale S.Eugenio

🇮🇹

Roma, Italy

Università Cattolica del Sacro Cuore - Policlinico A. Gemelli

🇮🇹

Roma, Italy

UOC Pronto Soccorso e Accettazione Ematologica - Dipartimento Biotecnologie Cellulari ed Ematologia - Università degli Studi di Roma "Sapienza"

🇮🇹

Roma, Italy

Istituto di Ematologia - IRCCS Ospedale Casa Sollievo della Sofferenza

🇮🇹

S. G. Rotondo, Italy

Clinica Ematologica - Policlinico Universitario

🇮🇹

Udine, Italy

ULSS N.6 Osp. S. Bortolo

🇮🇹

Vicenza, Italy

S.O.C. di Ematologia - Azienda Ospedaliera - SS. Antonio e Biagio e Cesare Arrigo

🇮🇹

Alessandria, Italy

Azienda Ospedaliera - Nuovo Ospedale "Torrette"

🇮🇹

Ancona, Italy

Sez. di Ematologia Clinica Ospedale San Francesco

🇮🇹

Nuoro, Italy

Azienda Ospedaliera di Rilievo Nazionale "A. Cardarelli"

🇮🇹

Napoli, Italy

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