Summary:The purpose of this study was to measure the trajectory of psychosocial recovery over the first year after bone marrow transplantation (BMT). BMT patients were assessed at baseline (n = 86), hospital discharge (n = 74), 100 days (n = 64) and at 1 year (n = 45). Participants completed the Functional Assessment of Cancer Therapy-Bone Marrow Transplant Scale (FACT-BMT), the Profile of Mood States Total Mood Disturbance Scale (POMS-TMDS), the Medical Outcomes Social Support Survey (MOS-SSS), the Center for Epidemiologic Studies-Depression (CES-D) scale screener, a performance Status Rating Scale (PSR), and an interview questionnaire. The recovery trajectory in this patient population showed three distinct trends. The trajectory for distress was linear and improved over time with approximately 20% of patients continuing to have psychological distress at 1 year. Secondly, the trend for overall quality of life was parabolic, worsening at discharge, then improving at 100 days and at 1 year. However, there were individual areas of deficit at follow-up, eg fatigue, even while overall quality of life mean scores improved. Thirdly, the trend for patient concerns over time was linear and worsening. These recovery trajectories suggest psychosocial interventions before and after BMT that may prepare patients for increasing and worsening concerns even as physical well-being improves. Keywords: quality of life; psychological distress; bone marrow transplantationThe psychological adaptation of bone marrow transplantation patients has been the subject of study for over 20 years.1 However, the first study indexed by the National Library of Medicine's Medline under both terms 'quality of life' and 'bone marrow transplantation' was published as recently as 1982.2 Case studies and clinical observations 1,3,4 have provided the impetus for post-transplant surveys designed to assess the psychological status and physical functioning of patients in cross-sectional, longitudinal stud- ies. [5][6][7][8][9][10][11][12] More recently, studies that employ a prospective longitudinal design measuring quality of life (QOL) both before and at multiple time points after transplantation have been utilized. [13][14][15][16] Several comprehensive reviews of the literature provide an overview of the numerous studies conducted to date. [17][18][19][20] Even with a developing consensus that post-BMT functioning can be satisfactory for most survivors, questions remain about how quickly patients recover a life of quality following BMT. For example, what concerns and problems do recipients experience in returning to normal during the 1 year time period post-BMT? 21,22 Our understanding of post-bone marrow transplant functioning has benefited greatly from surveys completed by patients following transplantation. However, patients who are assessed at variable time points months to years after transplantation do not represent a homogenous group. There is some evidence of a trajectory of recovery over the first year following transplantation. Patients may...

Pretransfusion medication of leukemia or BMT patients without a history of transfusion reaction does not decrease the overall risk of transfusion reactions. However, pretransfusion medication may decrease the risk of febrile nonhemolytic transfusion reactions to leukoreduced blood products.

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Hyporetinolemia is common, particularly in subjects with severe mucositis, and is associated with an increased risk of herpes zoster infection in recipients of hematopoietic stem cell transplant. Additional investigations are required to determine whether these findings indicate a causal relation.