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

L. M. H. Steur*, G. J. L. Kaspers, E. J. W. van Someren, N. K. A. van Eijkelenburg, I. M. van der Sluis, N. Dors, C. van den Bos, W. J. E. Tissing, M. A. Grootenhuis, R. R. L. van Litsenburg

*Corresponding author for this work

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Abstract

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

Original languageEnglish
Pages (from-to)5983-5993
Number of pages11
JournalSupportive Care in Cancer
Volume28
Issue number12
DOIs
Publication statusPublished - 13-Apr-2020

Keywords

  • Sleep
  • Cancer-related fatigue
  • Acute lymphoblastic leukemia
  • Pediatric
  • Actigraphy
  • Dexamethasone
  • QUALITY-OF-LIFE
  • CHILD SLEEP
  • DEXAMETHASONE
  • ACTIGRAPHY
  • PATTERNS
  • ADOLESCENTS
  • RELIABILITY
  • PREDNISONE
  • PEDSQL(TM)
  • VALIDITY

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