Comparison of psychologic outcome in adult survivors of childhood acute lymphoblastic leukemia versus sibling controls: A cooperative Children's Cancer Group and National Institutes of Health study

Purpose: To determine psychologic outcome, with the focus on emotional or mood state, of young adult survivors of childhood acute lymphoblastic leukemia (ALL) compared with sibling controls and to identify vulnerable subgroups at highest risk for negative mood. Patients and Methods: Adult survivors (n = 580), aged greater than or equal to 18 years, who were created before age 20 years on Children's Cancer Group (CCG) protocols for ALL and 396 sibling controls were administered a structured telephone interview and the Profile of Moods State (POMS), a standardized measure of affective state. Results: Survivors had higher total mood scores (which indicates greater negative mood) than sibling controls (P < .01) and reported more tension (P < .01), depression (P < .01), anger (P < .01), and confusion (P < .01), but not more fatigue or less vigor, Female, minority, and unemployed survivors reported the highest total time (P < .01) compared with controls. Conclusion: This large, sibling-controlled, multisite study of young adult survivors of childhood ALL treated on CCG protocols after 1970 found significant increased negative mood in survivors, not accounted for by reported energy level differences, which suggests that these emotional effects are not likely the result of current illness. Survivors are less likely to be fully employed. Female, minority, and unemployed survivors are at greatest risk for emotional sequelae, a finding that indicates the need for targeted, preventive intervention. (C) 1997 by American Society of Clinical Oncology.