Table 2.

Observed association between symptoms reported at four time points during therapy and relapse among cases of childhood ALL

	Median days from diagnosis (range)	Relapse Cases	Total Cases	Unadjusted Model HR (95% CI)	Adjusted Model1 HR (95% CI)
End Induction	47.5 (32.8 – 98.6)
Fatigue		20	177	1.19 (0.81–1.74)	1.28 (0.83–1.98)
Sleep		20	180	1.64 (1.02–2.62)	2.00 (1.11–3.62)
Pain		20	188	1.38 (1.09–1.74)	1.31 (0.98–1.75)
Nausea		20	187	1.15 (1.01–1.32)	1.19 (1.01–1.39)
Delayed Intensification Day 1	186.2 (94.9 – 262.8)
Fatigue		20	182	1.39 (0.91–2.13)	1.83 (1.23–2.73)
Sleep		19	177	1.93 (1.21–3.09)	1.73 (1.01–2.96)
Pain		19	189	1.22 (0.87–1.73)	1.80 (1.19–2.72)
Nausea		20	188	1.05 (0.88–1.24)	1.13 (0.95–1.35)
Maintenance Cycle 1 Day 1	288.4 (193.4 – 438.0)
Fatigue		16	166	1.65 (1.09–2.49)	2.14 (1.62–2.84)
Sleep		16	165	1.39 (0.78–2.48)	2.19 (1.10–4.35)
Pain		16	169	0.89 (0.53–1.49)	0.90 (0.55–1.45)
Nausea		15	166	0.90 (0.72–1.14)	1.08 (0.81–1.42)
Maintenance Cycle 2 Day 1	390.5 (321.2 – 525.6)
Fatigue		14	160	1.02 (0.67–1.55)	1.25 (0.80–1.96)
Sleep		11	153	1.82 (0.89–3.70)	2.13 (0.98–4.60)
Pain		14	159	0.70 (0.32–1.55)	0.83 (0.41–1.69)
Nausea		14	164	1.12 (0.87–1.44)	1.19 (0.98–1.45)

¹Model adjusted for age, gender, ethnicity, BMI z-score at diagnosis, diagnosis, and treatment risk group

^*per standard deviation increase in fatigue, 1 unit increase in sleep, 2 unit increase in pain, 10 unit increase in nausea