In this study, we investigated the quality of life (QoL) of long-term survivors with Hodgkin lymphoma who received high-dose chemotherapy (HDCT) followed by peripheral blood stem cell transplantation (PBSCT). QoL of this group was compared with QoL of patients who were treated with conventional chemotherapy and with QoL of the healthy German population. Two standardized questionnaires, the EORTC QLQ-C30 and the EQ-5D, including the visual analogue scale (VAS) were applied. A total of 98 patients were included in the study, all of them treated in our institution. Thirty-seven patients who received HDCT with PBSCT between 1986 and 2007 were compared with 61 patients treated with conventional chemotherapy and supplementary radiation between 1998 and 2009. The median follow-up for the HDCT group was 11 years. Statistical analysis with the one-sample t-test shows a reduced QoL of both groups of patients compared to the healthy population. Compared to the group of patients who received conventional chemotherapy, there is a tendency towards reduced QoL in patients with HDCT in all of the three main categories of the EORTC-QLQ-C30. However, these differences were not statistically significant, with the exception of the subcategory of dyspnoea, which was worse in the group that was treated with BCNU containing high-dose protocols. We conclude that the negative impact of both HDCT and conventional therapy on the QoL of long-term survivors with Hodgkin lymphoma should not be underestimated and should lead to the development of less toxic therapy strategies.
In this study we investigated the quality of life (QoL) of long-term survivors with follicular lymphoma (FL) after high-dose chemotherapy (HDCT) and autologous stem cell transplant (ASCT) using two standardized questionnaires. Altogether, 124 patients with FL were included in the study. A total of 63 patients received HDCT with ASCT, and this group was compared with 61 patients who were treated with rituximab and CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone) chemotherapy and supplementary radiation. In addition, the QoL of the patients was compared to the QoL of healthy people on the basis of two studies about the general health status of the German population. When the QoLs of the HDCT group and the conventional therapy group were compared, there was a tendency for better QoL in the HDCT group, maybe due to a higher proportion of patients in complete remission (CR) or a longer follow-up period in the HDCT group (8.5 years vs. 4.5 years in the conventional therapy group). In both the HDCT group and the conventional therapy group, the results of the questionnaires showed a reduced QoL compared to the healthy population. In this study, there was a tendency for better QoL in the HDCT group compared to the conventional therapy group. However, the negative impact of both HDCT and conventional therapy on the QoL of patients with follicular lymphoma should not be underestimated and should lead to the development of less toxic therapy strategies.
The aim of this retrospective study was to assess the safety and efficacy of bone marrow (BM) harvesting of allogeneic donors in an outpatient setting. Data of 226 related and unrelated donors who underwent BM harvest under general anesthesia at our institution from 2002 to 2014 were analyzed. Sixteen patients were a priori planned for admission for social reasons and 210 patients underwent BM harvesting with the intention to perform this procedure on an outpatient basis. To identify factors that predispose for hospital admission, we retrospectively analyzed donor characteristics and collection parameters. Outpatient treatment was performed in 178 of 210 donors (85%), whereas 32 donors (15%) required admission for clinical reasons (mainly clinically relevant anemia and circulatory problems). These individuals were not significantly different in sex distribution, age, donor's body weight, and the proportion of related donors from those who were not admitted. However, we found a significantly higher collection volume per kilogram donor's body weight in inpatients compared with volume for outpatients (16 versus 13 mL/kg body weight, P < .001). Severe adverse events or deaths occurred neither in the inpatient nor in the outpatient setting. Our study demonstrated that BM harvest in an outpatient setting is safe and feasible for the majority of allogeneic donors. A high volume of BM represented a major risk factor for inpatient admission.
The Thoraco-Pulmonary Medical Oncology is supported by Associazione Italiana per la Ricerca sul Cancro (AIRC) (no grant number applies). Disclosure Alessandro Morabito received honoraria from AstraZeneca, Bristol-Myers Squibb, Boehringer Ingelheim, Merck Sharp & Dohme, Pfizer and Roche. 'Who better than the patient to tell you whether the services we provide supply value or not?' (Carolyn Kerrigan)
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