Characteristics of pain-anxiety-depression-fatigue symptom clusters in adolescents with acute lymphoblastic leukemia during early chemotherapy
10.3969/j.issn.1672-8467.2025.06.004
- VernacularTitle:青少年急性淋巴细胞性白血病患者化疗早期疼痛-焦虑-抑郁-疲乏症状群的变化特征
- Author:
Lei CHENG
1
;
Yan-qing WANG
;
Hai-ying HUANG
;
Ling YU
;
Ming-xia DUAN
;
Xiao-rong MAO
Author Information
1. 复旦大学护理学院 上海 200032
- Publication Type:Journal Article
- Keywords:
adolescents;
acute lymphoblastic leukemia(ALL);
chemotherapy;
symptom clusters;
latent class
- From:
Fudan University Journal of Medical Sciences
2025;52(6):803-810
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the characteristics of changes in pain-anxiety-depression-fatigue symptom clusters and their possible associated factors in adolescents with acute lymphoblastic leukemia(ALL)during early chemotherapy.Methods A prospective longitudinal study was conducted from Nov 2019 to Oct 2021,enrolling newly diagnosed adolescent ALL patients from 5 tertiary or pediatric specialty hospitals in Shanghai,Zhejiang Province,Sichuan Province,Anhui Province and Guangdong Province.Patient-reported pain,anxiety,depression,and fatigue were collected at five time points within the first nine weeks of chemotherapy using the PROMIS Pediatric-25 instrument.Latent profile analysis(LPA)and latent transition analysis(LTA)were applied to explore the latent classes of symptom clusters,their transition probabilities over time,and possible risk or protective factors associated with class membership.Results A total of 134 ALL cases were enrolled,and symptom clusters at all the 5 time points(T1-T5)were consistently classified into three groups of mild,moderate and severe symptoms.The severe symptoms group accounted for the largest proportion at each time point(54.5%,59.7%,66.4%,49.3%,and 47.0%,respectively),while the mild and moderate symptoms groups showed an initial decline followed by an increase.Among participants,40.2%maintained the same symptom status,and 77.4%experienced at least one episode of severe symptom status during the trajectory.Religious affiliation(T5)and family monthly income>5 000 Yuan(T2,T4 and T5)served as protective factors against severe symptoms.Higher baseline fatigue(T1)was associated with membership in the severe symptoms group at subsequent time points.Conclusion Pain-anxiety-depression-fatigue symptoms in adolescents with ALL during early chemotherapy can be categorized into mild,moderate and severe symptoms with dynamic transitions over time.Higher baseline fatigue was associated with increased risk of severe symptoms,whereas higher family income and religious affiliation appeared protective effects.
