A prospective study of health-related quality of life, fatigue, anxiety and depression 3–5 years after stem cell transplantation

Few studies have evaluated long-term health-related quality of life (HRQL) in patients during auto-SCT. This prospective study examined HRQL in 96 eligible patients before, during and up to 3 years after auto-SCT. The aim of the study was to make a comprehensive assessment of the frequency and severity of different symptoms in patients undergoing auto-SCT. The European Organization for Treatment and Research of Cancer Quality of Life Questionnaire (EORTC QLQ C-30) was administered 13 times. The second week during treatment was the period when patients had the lowest HRQL regarding both total quality of life and function and symptom scales. The patients recovered quickly and just two months after transplantation the baseline values were restored. Three years after transplantation most of the items in the questionnaire had stabilized, except role function and dyspnea, which had improved. There were significant differences between multiple myeloma (MM) and lymphoma patients' physical function, quality of life, fatigue and pain during week 2. At the 3-year follow-up, lymphoma patients indicated a better HRQL than MM patients. The quick recovery of patients after transplantation suggests that treatment is well tolerated; however, the supportive care could be improved at week 2, especially for the lymphoma patients.

Section: Discussionsupporting

confidence: 63%

Section: Discussionmentioning

confidence: 99%

A prospective evaluation of patients' health-related quality of life during auto-SCT: a 3-year follow-up

Frödin

Börjeson

Lyth

et al. 2010

“…Sleep difficulties of participants receiving an allogeneic transplant were less pronounced before admission and worse during the inpatient treatment compared with patients who received an autologous transplant. The findings from two studies of Hjermstad et al 35,41 who measured sleep quality before admission are comparable.…”

Section: Discussionsupporting

confidence: 62%

Sleep disturbances and emotional distress in the acute course of hematopoietic stem cell transplantation

Rischer

Scherwath

Zander

et al. 2009

Recent research has shown that patients undergoing hematopoietic SCT (HSCT) experience multiple symptoms that can affect the sleep quality adversely. This study investigated the sleep quality of patient in the acute course of HSCT, and measured the impact of sociodemographic, medical, physical and psychological factors. Fifty patients were assessed before admission, 44 participated during inpatient treatment and 32 on day 100 ( ± 20) posttransplantation. Measuring instruments included the Pittsburgh Sleep Quality Index (PSQI) and a sleep diary (sleep quality), the European Organization for Research and Treatment of Cancer Quality of Life QuestionnaireCore 30 (health-related quality of life), the Hospital Anxiety and Depression Scale -German version (anxiety/depression) and the German version of the Cancer and Treatment Distress Scale (treatment-specific distress). The prevalence of sleep disturbances was 32% before admission, 77% during the hospital stay and 28% after discharge. Difficulty in maintaining sleep was the most intense sleep problem during the inpatient phase. This was mainly caused by disturbing noises and need to use the bathroom frequently. Sleep problems were significantly worse during the hospital stay compared with the other measurement points in time (Po0.001). A significant interaction was seen between the time course of sleep disturbances and the type of transplantation (P ¼ 0.001). The findings suggest that sleep disturbances after HSCT are particularly associated with physical functioning, fatigue and treatment-specific distress, and factors that contribute to sleep difficulties in the general population seem to be less important.

“…[12][13][14][15][16][17][18][19][20] Several studies have compared patient-reported QOL between allo-HCT and chemotherapy. [21][22][23][24][25][26][27] Zittoun et al 27 performed a cross-sectional study of the EORTC-GIMEMA AML 8 A trial and compare QOL after allo-HCT, autologous HCT and chemotherapy, and reported that allo-HCT had an adverse impact on the QOL. More recent cross-sectional studies 24,25 applied the EORTC Quality of Life Core Questionnaire (QLQ-C30) to a larger number of AML patients, and reported that patients who received allo-HCT had a significantly worse QOL.…”

Section: Introductionmentioning

confidence: 99%

Patient-reported quality of life after allogeneic hematopoietic cell transplantation or chemotherapy for acute leukemia

Kurosawa¹,

Yamaguchi

Mori

et al. 2015

When discussing treatment options for patients with acute leukemia, it is important to acknowledge the impact of allogeneic hematopoietic cell transplantation (allo-HCT) or chemotherapy on quality of life (QOL). We performed a cross-sectional questionnaire study that administered SF-36, FACT-Leukemia and EuroQOL5D to 524 acute leukemia survivors, to compare patientreported QOL between chemotherapy and allo-HCT, and to elucidate predictors of QOL. Patients who received chemotherapy alone had a better physical QOL than those who received allo-HCT. On the other hand, the allo-HCT group reported a better mental QOL. In the comparison of QOL in the allo-HCT patients according to the presence of GVHD at survey, patients who had GVHD symptoms experienced statistically and clinically significantly worse QOL than those who did not. In the allo-HCT patients without GVHD, the physical QOL was comparable to that in the chemotherapy patients, and they experienced significantly better mental and general QOL than the chemotherapy patients. GVHD and immunosuppressive drugs at survey were strongly associated with worse QOL after allo-HCT. In the chemotherapy group, a shorter time between treatment completion and survey was significantly associated with worse QOL. Further evaluation of QOL by a longitudinal assessment with quantitative and qualitative analyses are warranted.