The Influence of Oxidative Stress on Symptom Occurrence, Severity, and Distress During Childhood Leukemia Treatment

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To explore the symptom trajectory during the first 16 months of childhood leukemia treatment and any associations with the oxidative stress pathway measured by cerebrospinal fluid (CSF) concentration of oxidized phosphatidylcholine (PC), the predominant glycerophospholipid in the brain and cell membranes.


Prospective, longitudinal design.


Two cancer centers in the southwestern United States.


36 children (aged 3-14 years) newly diagnosed with acute lymphoblastic leukemia.


Symptoms were measured using the Memorial Symptom Assessment Scale at six specific time points during treatment. Biochemical changes in oxidative stress were measured by oxidized PC in the CSF.

Main Research Variables:

Childhood cancer symptoms, oxidized PC.


Significant differences were found in the number of symptoms experienced during the three phases of treatment. Symptom trajectory changes and influence of the oxidative stress pathway on symptom experiences were identified.


Symptoms experienced during treatment for childhood leukemia are associated with increased oxidative stress.

Implications for Nursing:

Children with leukemia experience symptoms throughout treatment. Physiologic measures indicate the influence of oxidative stress on symptoms.

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