Younger CLL Patients Suffer More from Depression, Anxiety in W&W

[Guest guest]

Quality of life, depression and anxiety in chronic lymphocytic

leukemia during phases of " watchful waiting " and active treatment.

Meeting: 2006 ASCO Annual Meeting

Abstract No: 6603

Citation: Journal of Clinical Oncology, 2006 ASCO Annual Meeting

Proceedings Part I. Vol 24, No. 18S (June 20 Supplement), 2006: 6603

Author(s): T. Levin

Abstract: Background: Although chronic lymphocytic leukemia (CLL)

accounts for 25-30% of leukemia cases in the USA, little is known

about its quality of life (QOL) and psychosocial burden. The purpose

of this study was to compare QOL, anxiety and depression in watch and

wait versus actively treated CLL.

Methods: Using a cross-sectional design, 105 patients were recruited

from a CLL research database. 57 were classified as watch and wait

and 48 as receiving or having received chemotherapy for CLL. The

patients completed a battery of QOL measures including the SF-36,

FACT-Lym, Beck Depression Inventory (BDI-II), Beck Anxiety Inventory

(BAI) and the Patient Health Questionnaire.

Results: No differences were found between the treatment groups on

the main QOL outcome measures - Mental Component Score, Physical

Component Score, FACT-G, FACT-lymphoma (15 item), BDI-II and BAI.

There was a clear age effect: younger patients (<60 years old) have

worse Mental Component (p=0.0001), FACT-G (p=0.060), depression

(p=0.014), Role Emotional (p=0.042), Mental Health (p=0.001), FACT-

Emotional (p=0.0001) and FACT-Social (p=0.002) scores.

Younger watch and wait patients seem to be particularly vulnerable to

anxiety (p=0.052). Social and emotional QOL are statistically similar

in both newly diagnosed and patients diagnosed six or more years ago,

although patients do carry a greater physical QOL burden with time

(p=0.05).

Conclusions: Overall QOL, depression and anxiety are remarkably

similar in watch and wait versus actively treated CLL, despite the

latter group having, by definition, later stage disease. Younger

patients (<60 years old) seem particularly vulnerable to having a

reduced emotional and social QOL and having more depression. Younger

watch and wait patients stood out as suffering from more anxiety.

Patients diagnosed for more than 6 years carry a greater physical QOL

burden, but social and emotional QOL are similar to newly diagnosed

patients. Implications of these findings are considered.

QOL, depression & anxiety in CLL: Watch & Wait vs. Active Treatment

WATCH AND WAIT

mean (SD) ACTIVE TREATMENT

mean (SD) WATCH & WAIT vs.

ACTIVE TREATMENT AGE AGE - TREATMENT

INTERACTION

Age < 60

(n = 34) Age>60

(n = 23) Age < 60

(n = 24) Age>60

(n = 24)

SF-36 Mental

Component

Score 49.34

(8.03) 55.64

(5.69) 46.85

(10.90) 53.72

(6.34) - p=0.0001 -

SF-36 Physical

Component

Score 52.82

(7.63) 50.01

(8.37) 53.22

(5.89) 45.55

(8.99) - p=0.001 -

FACT-G 52.67

(12.53) 57.69

(5.38) 52.72

(6.63) 54.42

(7.40) _ p=0.060 -

FACT-Lymphoma

(15 items) 47.09

(7.34) The lower mean scores on the FACT and SF-36, the better the

QOL colspan= " 1 " >50.57

(8.31) 48.21

(4.87) 46.15

(7.76) - - p=0.059

FACT-Lymphoma

Physical

(8 physical

items only) 27.59

(3.61) 27.65

(4.28) 28.25

(1.89) 25.82

(4.58) - - p=0.09

Beck Anxiety

Inventory 6.18

(5.47) 2.91

(3.04) 4.75

(4.01) 5.38

(6.46) - - p=0.052

Beck Depression

Inventory-II 8.09

(6.07) 4.75

(4.54) 8.62

(6.78) 6.39

(4.54) - p=0.014 -