Headache types, related morbidity, and quality of life in survivors of childhood acute lymphoblastic leukemia: a prospective cross sectional study

Abstract

Background: Increased headache prevalence was recently reported in survivors of childhood ALL. Headache sub types, related morbidity, and effect on quality of life has not been reported thus far.

Objective: To study headache prevalence and type, related disability, and quality of life in a cohort of childhood acute lymphoblastic leukemia (ALL) survivors.

Methods: Childhood ALL survivors in at least 1-year of remission and 5 years from diagnosis completed questionnaires and were evaluated by a neurologist. Disability was evaluated with Pediatric Migraine Disability Assessment scale and the Short Form-36 Health Survey assessed quality of life.

Results: Thirty nine of 72 (54%) females and 37 of 90 (41%) males reported headaches. Median time from ALL diagnosis to first headache was 5.2 years and median age at headache onset was 10.1 years in 76 participants with headache. Migraine headaches were diagnosed in 51 (31%) and episodic tension-type headaches in 49 (30%); migraine and tension-type headaches co-existed in 24 (15%) and 18 (11%) participants had chronic daily headaches. Fatigue was associated with migraine headache while hypertension and female gender associated with tension type headache. Headache-related disability was mild in 22 (29%), moderate in 7 (9%), and severe in 5 (7%) survivors, and was absent in the remaining 42 (55%) survivors with headache. Both migraine and tension type headaches associated with reduced mental component scores, while headache related disability associated with a reduced physical component scores.

Conclusions: Headaches are common in ALL survivors but only a minority has significant disability or impairment of quality of life.

Keywords: Acute lymphoblastic leukemia (ALL); Childhood; Headaches; Long-term survivor; Morbidity; Quality of life.

Conflict of interest statement

Authors disclosure, conflict of interest: The authors have no disclosures to report. There are no commercial, financial, or other associations that could pose a conflict of interest in connection with this submitted article.

Copyright © 2014 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

Figures

Figure 1. Recruitment and participation of patients

Consort diagram of accrual of patients based on eligibility with inclusion criteria for recruitment. The actual evaluable participants are those who agreed to participate, did not have scheduling conflicts, or who did not miss their appointments.