Identification of symptom trajectories in children with hematological malignancies along the chemotherapy cycle: A growth mixture model

Zhuting Zheng; Danyu Li; Changrong Yuan; Jingting Wang; Yingwen Wang; Ling Yu; Haiying Huang; Yanqing Wang; Wen Zhang

doi:10.1016/j.anr.2025.05.003

Identification of symptom trajectories in children with hematological malignancies along the chemotherapy cycle: A growth mixture model

Asian Nurs Res (Korean Soc Nurs Sci). 2025 Jun 25:S1976-1317(25)00060-X. doi: 10.1016/j.anr.2025.05.003. Online ahead of print.

Authors

Zhuting Zheng¹, Danyu Li¹, Changrong Yuan¹, Jingting Wang², Yingwen Wang³, Ling Yu³, Haiying Huang⁴, Yanqing Wang⁵, Wen Zhang⁶

Affiliations

¹ School of Nursing, Fudan University, Shanghai, China.
² School of Nursing, Naval Medical University, Shanghai, China.
³ The Children's Hospital of Fudan University, Shanghai, China.
⁴ Guangzhou Women and Children's Medical Center, Guangzhou, Guangdong, China.
⁵ The Children's Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
⁶ School of Nursing, Fudan University, Shanghai, China. Electronic address: zhangwennurs@fudan.edu.cn.

PMID: 40578680
DOI: 10.1016/j.anr.2025.05.003

Abstract

Purpose: To evaluate the longitudinal trajectories of chemotherapy-related symptoms over the first cycle of chemotherapy in a group of children with hematological malignancies at four time points and to identify the sociodemographic or disease characteristics of different trajectories.

Methods: The multicenter sample comprised 120 pairs of chemotherapy-treated children and their caregivers. We collected data on seven symptoms. A growth mixture model was used to identify symptom trajectories. Logistic regression analysis was used to compare the sociodemographic and clinical variables of the individuals during each trajectory.

Results: Three mobility trajectories, two anxiety trajectories, three depressive symptoms trajectories, three fatigue trajectories, two peer relationship trajectories, three pain interference trajectories, and three pain intensity trajectories were identified respectively. Moreover, children's age, sex, WBC index and caregiver's educational background differentially influenced the symptom trajectories.

Conclusion: This study identified important symptom trajectories in children with hematological malignancies. More stable variables have been associated with trajectories, and future preventive interventions should promote adaptive coping strategies.

Keywords: drug therapy; hematologic neoplasms; symptom burden.