COMPARISON OF PSYCHOLOGIC OUTCOME IN ADULT SURVIVORS OF CHILDHOOD ACUTE LYMPHOBLASTIC-LEUKEMIA VERSUS SIBLING CONTROLS - A COOPERATIVE CHILDRENS 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 lymphoblas tic leukemia (ALL) compared with sibling controls and to identify vuln erable subgroups at highest risk for negative mood. Patients and Metho ds: 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 struct ured telephone interview and the Profile of Moods State (POMS), a stan dardized measure of affective state. Results: Survivors had higher tot al mood scores (which indicates greater negative mood) than sibling co ntrols (P < .01) and reported more tension (P < .01), depression (P < .01), anger (P < .01), and confusion (P < .01), but not more fatigue o r 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 i ncreased negative mood in survivors, not accounted for by reported ene rgy level differences, which suggests that these emotional effects are not likely the result of current illness. Survivors are less likely t o be fully employed. Female, minority, and unemployed survivors are at greatest risk for emotional sequelae, a finding that indicates the ne ed for targeted, preventive intervention. (C) 1997 by American Society of Clinical Oncology.