Physical health conditions and quality of life in adults with primary immunodeficiency diagnosed during childhood: A French Reference Center for PIDs (CEREDIH) study - 19/04/17
, Nizar Mahlaoui, MD b, d, e, Pascal Auquier, MD, PhD c, Isabelle Pellier, MD, PhD b, f, Fanny Fouyssac, MD b, g, Camille Vercasson, MS c, Maya Allouche, SC a, Carolina Brito De Azevedo, SC b, Felipe Suarez, MD, PhD b, e, h, i, Despina Moshous, MD, PhD b, d, e, Bénédicte Neven, MD, PhD b, d, e, Marlène Pasquet, MD, PhD b, j, Eric Jeziorski, MD, PhD b, k, Nathalie Aladjidi, MD b, l, Nicolas Schleinitz, MD, PhD b, m, Caroline Thomas, MD b, n, Virginie Gandemer, MD, PhD b, o, Françoise Mazingue, MD b, p, Patrick Lutz, MD b, q, Olivier Hermine, MD, PhD b, e, h, Capucine Picard, MD, PhD b, d, e, Stéphane Blanche, MD, PhD b, d, e, Gérard Michel, MD a, b, c, Alain Fischer, MD, PhD b, d, e, rAbstract |
Background |
Most children with primary immunodeficiencies (PIDs) now reach adulthood. However, few studies have evaluated their health status and health-related quality of life (HRQoL).
Objective |
To investigate long-term morbidity, the French Reference Center for PIDs initiated a prospective multicenter cohort: the French Childhood Immune Deficiency Long-term Cohort. The data collected were used to assess the physical health condition of patients who reached adulthood and the effect on their quality of life.
Methods |
Patients were asked to complete health status questionnaires. A severity score (grade 1 [mild] to grade 4 [life-threatening]) was assigned to each health condition. The HRQoL of patients was compared with age- and sex-matched French normal values by using the 36-item Short-Form Survey (SF-36) HRQoL questionnaire.
Results |
Among 329 participants, the mean age at evaluation was 27.6 years, with a 21-year mean follow-up after diagnosis; 43% reported at least 1 grade 4 health condition, and 86% reported at least 1 grade 3 (severe) or 4 health condition. Twenty-five (7.6%) patients had been treated for cancer. Compared with the French normal values, adults with PIDs scored significantly lower for all HRQoL domains. HRQoL was strongly associated with the burden of health conditions. The association with grade 4 or grade 3-4 health conditions was highly significant for all physical and mental domains.
Conclusion |
Adults with PIDs diagnosed during childhood experienced a heavy burden of health conditions, which affected their HRQoL. Our results emphasize the need to closely monitor this vulnerable population.
Le texte complet de cet article est disponible en PDF.Key words : Primary immunodeficiency, childhood, young adults, health status, quality of life
Abbreviations used : CEREDIH, CTCAE, CVID, ENT, F-CILC, F-CILSG, HRQoL, HSCT, PID, SF-36
Plan
| Supported by the French National Program for Clinical Research (PHRC; EudraCT trial no. 2012-A0033-35, Ministry of Health). |
|
| Disclosure of potential conflict of interest: N. Schleinitz has received board membership from Baxalta, LFB, and CSL Behring and payment for lectures from LFB and CSL Behring. O. Hermine has received board membership and consultancy fees from AB Science; he or his institution has received grants pending from AB science, Novartis, and Celgene; and he has stock options with AB science. G. Michel has received a grant from the French National Program for Clinical Research for this work under consideration for publication. The rest of the authors declare that they have no relevant conflicts of interest. |
Vol 139 - N° 4
P. 1275 - avril 2017 Retour au numéro
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