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Published in: Health and Quality of Life Outcomes 1/2019

Open Access 01-12-2019 | Hemophilia | Research

Health-related quality of life in children with haemophilia in China: a 4-year follow-up prospective cohort study

Authors: Heng Zhang, Jie Huang, Xiaoyan Kong, Gaoxiang Ma, Yongjun Fang

Published in: Health and Quality of Life Outcomes | Issue 1/2019

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Abstract

Background

Health-related quality of life (HRQoL) has been brought up for decades in haemophilia patients. However, no data to date are available about HRQoL in children with haemophilia using long-term follow up data. This nearly 4-year follow-up study aimed to assess the long-term HRQoL of haemophilia children.

Methods

A prospective cohort study among 42 children with haemophilia and their parents was conducted in August 2014 in a children’s hospital; follow-up was completed in January 2018. Primary endpoint was the change in patient HRQoL evaluated by Canadian Haemophilia Outcomes–Kids’ Life Assessment Tool (CHO-KLAT) from baseline to year 4; secondary endpoint was the impact of bleeding rates, physical activity restriction, financial burden and treatment (prophylaxis vs on-demand treatment) on HRQoL, as well as the impact of treatment on event-free survival.

Results

Totally 42 patients (mean age, 5.48[SD, 4.63] years) and 42 parents were included. 38 families completed 4-year follow up. Patients reported a small increase in HRQoL from baseline to year 4. The mean scores of child self-report and parent proxy report of CHO-KLAT at baseline were 60.69 (SD = 20.28) and 61.01 (SD = 12.14), respectively. Scores at follow-up were 64.69 (SD = 13.71) and 65.33 (SD = 15.78), respectively. Haemophilia patients without physical activity restriction, living in urban areas, and receiving prophylactic treatment and home injection, had higher average values for HRQoL scores than the others. Bleeding rates were proportionally negatively correlated with HRQoL. Patients who had received prophylactic treatment had better event-free survival.

Conclusions

Haemophilia decreased HRQoL of patients, but this effect weakened after 4 years. HRQoL of children is influenced by severity of haemophilia, bleeding rates, physical activity restriction, financial burden and treatment. Prophylactic treatment is a key factor contributing to event-free survivor prognosis and the optimal form of therapy for childhood haemophilia.
Literature
1.
go back to reference Mannucci PM, Tuddenham EG. The hemophilias--from royal genes to gene therapy. N Engl J Med. 2001;344:1773–9.CrossRef Mannucci PM, Tuddenham EG. The hemophilias--from royal genes to gene therapy. N Engl J Med. 2001;344:1773–9.CrossRef
2.
go back to reference Ljung R, Gretenkort Andersson N. The current status of prophylactic replacement therapy in children and adults with haemophilia. Br J Haematol. 2015;169:777–86.CrossRef Ljung R, Gretenkort Andersson N. The current status of prophylactic replacement therapy in children and adults with haemophilia. Br J Haematol. 2015;169:777–86.CrossRef
3.
go back to reference Ljung RC. Intracranial haemorrhage in haemophilia a and B. Br J Haematol. 2008;140:378–84.CrossRef Ljung RC. Intracranial haemorrhage in haemophilia a and B. Br J Haematol. 2008;140:378–84.CrossRef
4.
go back to reference White GC 2nd, Rosendaal F, Aledort LM, Lusher JM, Rothschild C, Ingerslev J, Factor V, Factor IXS. Definitions in hemophilia. Recommendation of the scientific subcommittee on factor VIII and factor IX of the scientific and standardization committee of the International Society on Thrombosis and Haemostasis. Thromb Haemost. 2001;85:560.CrossRef White GC 2nd, Rosendaal F, Aledort LM, Lusher JM, Rothschild C, Ingerslev J, Factor V, Factor IXS. Definitions in hemophilia. Recommendation of the scientific subcommittee on factor VIII and factor IX of the scientific and standardization committee of the International Society on Thrombosis and Haemostasis. Thromb Haemost. 2001;85:560.CrossRef
5.
go back to reference Srivastava A, Brewer AK, Mauser-Bunschoten EP, Key NS, Kitchen S, Llinas A, Ludlam CA, Mahlangu JN, Mulder K, Poon MC, et al. Guidelines for the management of hemophilia. Haemophilia. 2013;19:e1–47.CrossRef Srivastava A, Brewer AK, Mauser-Bunschoten EP, Key NS, Kitchen S, Llinas A, Ludlam CA, Mahlangu JN, Mulder K, Poon MC, et al. Guidelines for the management of hemophilia. Haemophilia. 2013;19:e1–47.CrossRef
6.
go back to reference Manco-Johnson MJ, Abshire TC, Shapiro AD, Riske B, Hacker MR, Kilcoyne R, Ingram JD, Manco-Johnson ML, Funk S, Jacobson L, et al. Prophylaxis versus episodic treatment to prevent joint disease in boys with severe hemophilia. N Engl J Med. 2007;357:535–44.CrossRef Manco-Johnson MJ, Abshire TC, Shapiro AD, Riske B, Hacker MR, Kilcoyne R, Ingram JD, Manco-Johnson ML, Funk S, Jacobson L, et al. Prophylaxis versus episodic treatment to prevent joint disease in boys with severe hemophilia. N Engl J Med. 2007;357:535–44.CrossRef
7.
go back to reference Remor E, Young NL, Von Mackensen S, Lopatina EG. Disease-specific quality-of-life measurement tools for haemophilia patients. Haemophilia. 2004;10(Suppl 4):30–4.CrossRef Remor E, Young NL, Von Mackensen S, Lopatina EG. Disease-specific quality-of-life measurement tools for haemophilia patients. Haemophilia. 2004;10(Suppl 4):30–4.CrossRef
8.
go back to reference Young NL, Bradley CS, Wakefield CD, Barnard D, Blanchette VS, McCusker PJ. How well does the Canadian Haemophilia outcomes-Kids' life assessment tool (CHO-KLAT) measure the quality of life of boys with haemophilia? Pediatr Blood Cancer. 2006;47:305–11.CrossRef Young NL, Bradley CS, Wakefield CD, Barnard D, Blanchette VS, McCusker PJ. How well does the Canadian Haemophilia outcomes-Kids' life assessment tool (CHO-KLAT) measure the quality of life of boys with haemophilia? Pediatr Blood Cancer. 2006;47:305–11.CrossRef
9.
go back to reference Broderick CR, Herbert RD, Latimer J, Curtin JA. Fitness and quality of life in children with haemophilia. Haemophilia. 2010;16:118–23.CrossRef Broderick CR, Herbert RD, Latimer J, Curtin JA. Fitness and quality of life in children with haemophilia. Haemophilia. 2010;16:118–23.CrossRef
10.
go back to reference van der Net J, Vos RC, Engelbert RH, van den Berg MH, Helders PJ, Takken T. Physical fitness, functional ability and quality of life in children with severe haemophilia: a pilot study. Haemophilia. 2006;12:494–9.CrossRef van der Net J, Vos RC, Engelbert RH, van den Berg MH, Helders PJ, Takken T. Physical fitness, functional ability and quality of life in children with severe haemophilia: a pilot study. Haemophilia. 2006;12:494–9.CrossRef
11.
go back to reference St-Louis J, Urajnik DJ, Menard F, Cloutier S, Klaassen RJ, Ritchie B, Rivard GE, Warner M, Blanchette V, Young NL. Generic and disease-specific quality of life among youth and young men with hemophilia in Canada. BMC Hematol. 2016;16:13.CrossRef St-Louis J, Urajnik DJ, Menard F, Cloutier S, Klaassen RJ, Ritchie B, Rivard GE, Warner M, Blanchette V, Young NL. Generic and disease-specific quality of life among youth and young men with hemophilia in Canada. BMC Hematol. 2016;16:13.CrossRef
12.
go back to reference Krasuska M, Riva S, Fava L, von Mackensen S, Bullinger M. Linking quality-of-life measures using the international classification of functioning, disability and health and the international classification of functioning, disability and health-children and youth version in chronic health conditions: the example of young people with hemophilia. Am J Phys Med Rehabil. 2012;91:S74–83.CrossRef Krasuska M, Riva S, Fava L, von Mackensen S, Bullinger M. Linking quality-of-life measures using the international classification of functioning, disability and health and the international classification of functioning, disability and health-children and youth version in chronic health conditions: the example of young people with hemophilia. Am J Phys Med Rehabil. 2012;91:S74–83.CrossRef
13.
go back to reference Taha MY, Hassan MK. Health-related quality of life in children and adolescents with hemophilia in Basra, southern Iraq. J Pediatr Hematol Oncol. 2014;36:179–84.CrossRef Taha MY, Hassan MK. Health-related quality of life in children and adolescents with hemophilia in Basra, southern Iraq. J Pediatr Hematol Oncol. 2014;36:179–84.CrossRef
14.
go back to reference McCusker PJ, Fischer K, Holzhauer S, Meunier S, Altisent C, Grainger JD, Blanchette VS, Burke TA, Wakefield C, Young NL. International cross-cultural validation study of the Canadian haemophilia outcomes: kids' life assessment tool. Haemophilia. 2015;21:351–7.CrossRef McCusker PJ, Fischer K, Holzhauer S, Meunier S, Altisent C, Grainger JD, Blanchette VS, Burke TA, Wakefield C, Young NL. International cross-cultural validation study of the Canadian haemophilia outcomes: kids' life assessment tool. Haemophilia. 2015;21:351–7.CrossRef
15.
go back to reference Wu R, Sun J, Xiao J, Liu Y, Xue F, Wang H, Tang L, Zhao Y, Li K, Yang R, et al. A prospective study of health-related quality of life of boys with severe haemophilia a in China: comparing on-demand to prophylaxis treatment. Haemophilia. 2017;23:430–6.CrossRef Wu R, Sun J, Xiao J, Liu Y, Xue F, Wang H, Tang L, Zhao Y, Li K, Yang R, et al. A prospective study of health-related quality of life of boys with severe haemophilia a in China: comparing on-demand to prophylaxis treatment. Haemophilia. 2017;23:430–6.CrossRef
16.
go back to reference Tang L, Xu W, Li CG, Hou F, Feng XQ, Wang H, Li XJ, Li WL, Liu JP, Sun LR, et al. Describing the quality of life of boys with haemophilia in China: results of a multicentre study using the CHO-KLAT. Haemophilia. 2018;24:113–9.CrossRef Tang L, Xu W, Li CG, Hou F, Feng XQ, Wang H, Li XJ, Li WL, Liu JP, Sun LR, et al. Describing the quality of life of boys with haemophilia in China: results of a multicentre study using the CHO-KLAT. Haemophilia. 2018;24:113–9.CrossRef
17.
go back to reference Bradley CS, Bullinger M, McCusker PJ, Wakefield CD, Blanchette VS, Young NL. Comparing two measures of quality of life for children with haemophilia: the CHO-KLAT and the Haemo-QoL. Haemophilia. 2006;12:643–53.CrossRef Bradley CS, Bullinger M, McCusker PJ, Wakefield CD, Blanchette VS, Young NL. Comparing two measures of quality of life for children with haemophilia: the CHO-KLAT and the Haemo-QoL. Haemophilia. 2006;12:643–53.CrossRef
18.
go back to reference Young NL, Wakefield C, Burke TA, Ray R, McCusker PJ, Blanchette V. Updating the Canadian hemophilia outcomes-kids life assessment tool (CHO-KLAT Version2.0). Value Health. 2013;16:837–41.CrossRef Young NL, Wakefield C, Burke TA, Ray R, McCusker PJ, Blanchette V. Updating the Canadian hemophilia outcomes-kids life assessment tool (CHO-KLAT Version2.0). Value Health. 2013;16:837–41.CrossRef
19.
go back to reference Wu R, Zhang J, Luke KH, Wu X, Burke T, Tang L, Poon MC, Li X, Zhou M, Sun J, et al. Cross-cultural adaptation of the CHO-KLAT for boys with hemophilia in rural and urban China. Health Qual Life Outcomes. 2012;10:112.CrossRef Wu R, Zhang J, Luke KH, Wu X, Burke T, Tang L, Poon MC, Li X, Zhou M, Sun J, et al. Cross-cultural adaptation of the CHO-KLAT for boys with hemophilia in rural and urban China. Health Qual Life Outcomes. 2012;10:112.CrossRef
20.
go back to reference Wu R, Luke KH. The benefit of low dose prophylaxis in the treatment of hemophilia: a focus on China. Expert Rev Hematol. 2017;10:995–1004.CrossRef Wu R, Luke KH. The benefit of low dose prophylaxis in the treatment of hemophilia: a focus on China. Expert Rev Hematol. 2017;10:995–1004.CrossRef
21.
go back to reference Manco-Johnson MJ, Soucie JM, Gill JC. Joint outcomes Committee of the Universal Data Collection USHTCN: prophylaxis usage, bleeding rates, and joint outcomes of hemophilia, 1999 to 2010: a surveillance project. Blood. 2017;129:2368–74.CrossRef Manco-Johnson MJ, Soucie JM, Gill JC. Joint outcomes Committee of the Universal Data Collection USHTCN: prophylaxis usage, bleeding rates, and joint outcomes of hemophilia, 1999 to 2010: a surveillance project. Blood. 2017;129:2368–74.CrossRef
22.
23.
go back to reference Zilber R, Bortz AP, Yacobovich J, Yaniv I, Tamary H. Analysis of health-related quality of life in children with immune thrombocytopenia and their parents using the kids' ITP tools. J Pediatr Hematol Oncol. 2012;34:2–5.CrossRef Zilber R, Bortz AP, Yacobovich J, Yaniv I, Tamary H. Analysis of health-related quality of life in children with immune thrombocytopenia and their parents using the kids' ITP tools. J Pediatr Hematol Oncol. 2012;34:2–5.CrossRef
24.
go back to reference Vepsalainen K, Riikonen P, Lassila R, Arola M, Huttunen P, Lahteenmaki P, Mottonen M, Selander T, Martikainen J. Long-term clinical and economic outcomes in previously untreated paediatric patients with severe haemophilia a: a nationwide real-world study with 700 person-years. Haemophilia. 2018. Vepsalainen K, Riikonen P, Lassila R, Arola M, Huttunen P, Lahteenmaki P, Mottonen M, Selander T, Martikainen J. Long-term clinical and economic outcomes in previously untreated paediatric patients with severe haemophilia a: a nationwide real-world study with 700 person-years. Haemophilia. 2018.
Metadata
Title
Health-related quality of life in children with haemophilia in China: a 4-year follow-up prospective cohort study
Authors
Heng Zhang
Jie Huang
Xiaoyan Kong
Gaoxiang Ma
Yongjun Fang
Publication date
01-12-2019
Publisher
BioMed Central
Keyword
Hemophilia
Published in
Health and Quality of Life Outcomes / Issue 1/2019
Electronic ISSN: 1477-7525
DOI
https://doi.org/10.1186/s12955-019-1083-3

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