We examined the course and the prevalence of a high fear of cancer recurrence (FCR) in patients undergoing allogeneic PBSC transplantation (hematopoietic SCT (HSCT)) before HSCT (N = 239), 100 days after (n = 150, and 12 months after allogeneic HSCT (n = 102). The Fear of Progression Questionnaire-Short Form (FoP-Q-SF), the EORTC Quality of Life Questionnaire, and the Hospital Anxiety and Depression Scale were used. Pre-HSCT 36% of patients, 100 days after HSCT 24% of patients, and 1 year after HSCT 23% of patients fulfilled the criteria for high FCR (FoP-Q-SF cutoff = 34). Being married (b = 2.76, P = 0.026), female gender (b = 4.45, Po 0.001) and depression (b = 4.44, P o 0.001) were significantly associated with FCR at baseline. One hundred days after HSCT, depression significantly predicted FCR (b = 6.46, Po 0.001). One year following HSCT, female gender (b = 6.61, P = 0.008) and higher depression were (b = 4.88, P = 0.004) significant predictors for FCR. Over the three assessment points, patients with high FCR had a significantly lower quality of life compared to patients with low FCR in physical functioning (P = 0.019), role functioning (P = 0.003), emotional functioning (P o 0.001), cognitive functioning (P = 0.003), social functioning (P o 0.001) and global quality of life (P o 0.001). Our data provide evidence that FCR is a prevalent problem in patients with hematological malignancies and has a significant adverse impact on health-related quality of life.

Below average cognitive performance is common in this patient group. In addition, a subgroup shows reliable cognitive decline after allogeneic HSCT. Healthcare professionals should be aware of these treatment-related cognitive side effects.

Postoperative radiochemotherapy with 30-33 daily doses of temozolomide (75 mg/m(2)) is safe in patients with malignant glioma. The combined schedule is effective in oligodendroglioma patients and may prolong survival in glioblastoma. Effort should be taken to minimize corticosteroid doses, since both steroids and temozolomide lead to immunosuppression.

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BCS in combination with IORT in IBTR in pre-irradiated patients is a feasible method to avoid mastectomy with a low risk of side effects and an excellent local control and good overall survival.