Back pain among long-term survivors of childhood leukemia.

BACKGROUND: The objectives of this study are to determine the prevalence and relative risk (RR) of back pain and identify possible mechanisms of back pain among childhood acute lymphoblastic leukemia (ALL) survivors. METHODS: Surveys were mailed to 5 + -year survivors of childhood ALL aged 13 to 25 years. Survivors' siblings were also invited to participate in the study. Prevalence of back pain and hip pain among ALL survivors was determined and compared with siblings. Sex, treatment with radiation therapy, obesity, and physical activity were examined for an association with back pain and hip pain. RESULTS: Forty-four of 99 (44.4%) ALL survivors reported back pain compared with 11 of 52 (21.2%) their siblings (P = 0.007; RR: 2.01; 95% confidence interval = 1.15-3.56). In contrast, 10 of 99 (10.1%) ALL survivors reported experiencing hip pain compared with 1 of 52 (2.0%) siblings experiencing hip pain [P = 0.07; RR: 4.95 (0.65 to 37.57)]. Twenty-six of 43 female survivors reported back pain compared with 18 of 56 male survivors who reported back pain (P = 0.005). Obesity, physical activity, and treatment with radiation therapy were not associated with back pain or hip pain. CONCLUSIONS: This is the first study demonstrating an increased frequency of back pain among survivors of childhood ALL. Future studies are needed to better define the causes of back pain among childhood ALL survivors.

Health-related quality of life in children and adolescents with sickle cell disease.

OBJECTIVE: To assess health-related quality of life (HRQOL) in children and adolescents with sickle cell disease (SCD). DESIGN, SETTING, AND PARTICIPANTS: The PedsQL 4.0 Generic Scales, a multidimensional self-report instrument that has been shown to be valid and reliable for use in children and adolescents with chronic illness, consists of 23 items that assess physical, emotional, social, and school functioning. Questionnaires were administered to 124 children and adolescents (ages 8 to 18 years, child self-report) with SCD (100 sickle cell anemia, 24 sickle ß zero thalassemia) and their parents (parent-proxy report). Summary scores for children's and parents' ratings of overall HRQOL and psychosocial health and subscale scores for physical, emotional, social, and school functioning were compared with published data for healthy children. Both summary and subscale scores for children with SCD also were compared with those of their parents. RESULTS: Children with SCD and their parents rated overall HRQOL and all subdomains of HRQOL lower than did healthy children and their parents (P < .001). Children with SCD rated their own HRQOL significantly better than their parents did for overall HRQOL and all subdomains (P < .001) except emotional functioning (P = .06). CONCLUSIONS: Children with SCD and their parents perceived overall HRQOL and all HRQOL subdomains to be lower than scores reported in healthy children. Therefore, successful therapeutic efforts to improve HRQOL could represent important advances in the health of children with SCD.