Changes in children's reports of symptom occurrence and severity during a course of myelosuppressive chemotherapy

J Pediatr Oncol Nurs. Nov-Dec 2010;27(6):307-15. doi: 10.1177/1043454210377619. Epub 2010 Aug 25.


The purposes of this study in children who underwent a cycle of myelosuppressive chemotherapy were to describe changes in symptom occurrence and severity during the chemotherapy cycle. Patients (N = 66) 10 to 18 years of age completed the Memorial Symptom Assessment Scale for 10- to 18-year-olds (MSAS 10-18) at the start of a chemotherapy cycle (T1) and weekly for the next 2 weeks (T2 and T3). More than 30% of children reported 10 or more symptoms at all 3 time points. Symptom occurrence trajectories were tested with multilevel logistic regression. In all, 6 symptoms (ie, fatigue, sadness, irritability, worrying, weight loss, sweating) showed a decreasing linear trend. Significant quadratic patterns of change were found for feeling drowsy, nausea, and vomiting. Changes in symptom severity over time were evaluated with multilevel negative binomial regression. No significant differences over time were found in any of the symptom severity scores on the MSAS. Children experienced a high number of symptoms at the initiation of a chemotherapy cycle that persisted over the subsequent 2 weeks.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Age Factors
  • Analysis of Variance
  • Antineoplastic Agents / adverse effects*
  • Antineoplastic Agents / therapeutic use
  • Bone Marrow / drug effects
  • Child
  • Child Welfare
  • Female
  • Health Status Indicators
  • Humans
  • Immunosuppressive Agents / adverse effects*
  • Karnofsky Performance Status
  • Logistic Models
  • Longitudinal Studies
  • Male
  • Multivariate Analysis
  • Neoplasms / drug therapy*
  • Odds Ratio
  • Oncology Nursing
  • Pediatric Nursing
  • Self Report*
  • Severity of Illness Index
  • Surveys and Questionnaires


  • Antineoplastic Agents
  • Immunosuppressive Agents