ArticlePediatric blood & cancer2021
Pediatric lymphoma patients in Malawi present with poor health-related quality of life at diagnosis and improve throughout treatment and follow-up across all Pediatric PROMIS-25 domains.
Article in Pediatric blood & cancer, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it, 16 citations in OpenAlex.
- Prevalence of undernutrition in children with cancer in low-income and middle-income countries: a systematic review.BMJ global health · 2025Pooled it
- Generic health-related quality of life instruments among children and adolescents in low- and middle-income countries: a scoping review.Systematic reviews · 2026Article
- Assessment and Non-pharmacological Management of Chronic Pain in Pediatric Cancer Survivors: Current Practices and Recommendations for Next Steps.Current pain and headache reports · 2025Review
- Childhood Cancer Survivorship Care in Limited Resource Settings: A Narrative Review and Strategies to Promote Global Health Equity.JCO global oncology · 2025Review
- Measurement properties of the EQ-5D-Y-3L, PedsQL 4.0, and PROMIS-25 Profile v2.0 in pediatric patients with spinal muscular atrophy.Health and quality of life outcomes · 2024Article
- Declining incidence and improving survival of ocular and orbital lymphomas in the US between 1995 and 2018.Scientific reports · 2024Article
- Prevalence of Undernutrition Among Children and Adolescents with Cancer Living in Sub-Saharan African Countries: A Systematic Review and Meta-analysis.Global pediatric health · 2024Review
- Patient-reported outcome measures in children, adolescents, and young adults with palliative care needs-a scoping review.BMC palliative care · 2023Article
- Factors associated with health-related quality of life in a cohort of cancer survivors in New Jersey.BMC cancer · 2023Article
- Developing a Symptom Toolkit for Adult Lymphoma Patients Receiving Chemotherapy in Malawi.Palliative medicine reportsArticle
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Authors and funding
17 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundPatient-reportedoutcomes (PROs) that assess health-related quality of life (HRQoL) are increasingly important components of cancer care and research that are infrequently used in sub-Saharan Africa (SSA).
methodsWe administered the Chichewa Pediatric Patient-Reported Outcome Measurement Information System Pediatric (PROMIS)-25 at diagnosis, active treatment, and follow-up among pediatric lymphoma patients in Lilongwe, Malawi. Mean scores were calculated for the six PROMIS-25 HRQoL domains (Mobility, Anxiety, Depressive Symptoms, Fatigue, Peer Relationships, Pain Interference). Differences in HRQoL throughout treatment were compared using the minimally important difference (MID) and an ANOVA analysis. Kaplan-Meier survival estimates and Cox hazard ratios for mortality are reported.
resultsSeventy-five children completed PROMIS-25 surveys at diagnosis, 35 (47%) during active treatment, and 24 (32%) at follow-up. The majority of patients died (n = 37, 49%) or were lost to follow-up (n = 6, 8%). Most (n = 51, 68%) were male, median age was 10 (interquartile range [IQR] 8-12), 48/73 (66%) presented with advanced stage III/IV, 61 (81%) were diagnosed with Burkitt lymphoma and 14 (19%) Hodgkin lymphoma. At diagnosis, HRQoL was poor across all domains, except for Peer Relationships. Improvements in HRQoL during active treatment and follow-up exceeded the MID. On exploratory analysis, fair-poor PROMIS Mobility <40 and severe Pain Intensity = 10 at diagnosis were associated with increased mortality risk and worse survival, but were not statistically significant.
conclusionsPediatric lymphoma patients in Malawi present with poor HRQoL that improves throughout treatment and survivorship. Baseline PROMIS scores may provide important prognostic information. PROs offer an opportunity to include patient voices and prioritize holistic patient-centered care in low-resource settings.
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