A Multimethod Assessment of Psychosocial Functioning and Late Effects in Survivors of Childhood Cancer and Hematopoietic Cell Transplant

Abstract

Previous research in childhood cancer and hematopoietic cell transplant (HCT) survivorship has relied on the use of standardized questionnaires that assess symptoms of psychological functioning but do not sufficiently capture the cancer survivorship experience. Study aims are to quantitatively and qualitatively assess the psychosocial functioning of pediatric cancer and HCT survivors seen in a multidisciplinary survivorship clinic, determine survivorship concerns, and assess potential demographic and medical correlates of psychosocial outcomes. Data were collected using a retrospective chart review of a parent-report questionnaire of the child's psychological functioning, responses to a semistructured interview that qualitatively assessed adjustment to life after treatment, and documented medical late effects. Results indicated the majority of survivors had healthy psychological adjustment based upon a parent-report questionnaire. However, nearly 72% of survivors reported 1 or more survivorship concerns during the interview, with the primary concerns being current and future health or physical functioning, including the possibility of cancer recurrence. A content analysis of the interview responses indicated HCT survivors had more school or cognitive functioning concerns compared with survivors who did not have an HCT. Further research should use survivorship-specific measures to better identify survivors at risk and determine the impact of late effects on their quality of life.

Psychopathological Aspects in Childhood Hematopoietic Stem Cell Transplantation (HSCT): The Perception of Parents and Adolescents

“…Social problems were predicted by a longer time elapsed between the communication of the need to transplant and the actual transplantation, by the presence of longer hospitalizations, and by the presence of intensification with double HSCT, suggesting that the concrete limitations in activities subsequent to medical procedures that patients experience could significantly impact on their relationships with peers. Finally, the variables considered also predicted attention symptoms, in line with the studies that pointed out the possible impact that hospitalizations and medical procedures may have on the cognitive functioning of psychiatric patients (Bingen et al, 2012). …”

“…It is possible to speculate as to whether HSCT survivors could experience anticipatory fear linked to their previous traumatic experience and express it through worries about physical well-being, a hypothesis that could in part explain the parallel presence of high scores on somatic symptoms and low scores on post-traumatic stress symptoms (Bingen et al, 2012; Ahomäki et al, 2015). …”

Retroperitoneal Immature Teratoma in a Neonate

“…[ 5 ]; of these, two were immature and both succumbed to the disease. The presence of nephroblastic components is extremely rare in retroperitoneal teratomas [ 6 ]. It is also difficult to differentiate retroperitoneal immature teratoma from retroperitoneal neurogenic and yolk sac tumors, which occurs mostly in the axis of the body [ 7 ].…”

Life at the interface: Adults with “pediatric” disorders of the nervous system

“…The medical imperative for surveillance for recurrence of cancer and sequelae of its treatment is difficult enough. But the social and psychological challenges of becoming an adult at more than average risk for cancer and its sequelae are uniquely problematic . How do you lose the sense of your own mortality?…”