Charting Health Challenges for Digital Preventive Interventions: A National Long-Term Follow-up Study of Self-Rated Health Outcomes in Adult Survivors of Childhood Acute Lymphoblastic Leukemia (Preprint)

Abstract

Digital health interventions have emerged as a promising solution to address challenges faced by adult long-term survivors of childhood Acute Lymphoblastic Leukemia (ALL) in participating in health promotion and prevention programs, offering potential solutions to geographic mobility, limited institutional representation, and time constraints.

This study aims to enhance our understanding of health outcomes in this group, enabling the development of tailored digital interventions, and employs a nationwide cross-sectional approach to compare outcomes between ALL survivors treated with chemotherapy only and those who received hematopoietic stem cell transplantation (HSCT), compared to siblings.

In a cross-sectional national study, adult survivors (≥ 18y) of childhood ALL >10 y after diagnosis were compared to siblings regarding mental and physical health-related factors including sleep, stress, anxiety, and depression (DASS 21), several dimensions of fatigue (MFI 20), work ability (WAI), chronic pain, and prevalence of diabetes, cardiovascular disease, headache/migraine, and rheumatic disease.

In all, 426 of 855 eligible ALL survivors, with a mean age of 30.9 y (SD 7.7), 24y (SD 6.9) after ALL diagnosis, and 135 siblings with mean age 31.5 y (SD 7.7) responded. The ALL survivors had significantly lower sleep quality, quantity, and mean work ability and higher mean physical fatigue, reduced motivation, and activity than the siblings. There were no significant differences in levels between the groups on BMI, prevalence of chronic pain, depression, anxiety, or stress. The physical and psychological complications were more frequent among the adult ALL survivors who had been treated with HSCT.

Our nationwide cross-sectional study addresses the scarcity of knowledge regarding the health outcomes of adult survivors of childhood ALL. We highlight significant disparities within this population emphasizing the potential of comprehensive digital interventions that target vitality, sleep quality, fatigue, and psychosocial well-being, to enhance well-being and bolster the capacity to manage chronic health conditions. Such interventions would align with the needs of the target group, which is a prerequisite to successful incorporation of technology into their daily lives.