Dynamic assessment of quality of life after autologous bone marrow transplantation

Abstract

To determine the quality of life in adult patients after autologous bone marrow transplantation (BMT), we administered a questionnaire to a cohort of patients seen at a single referral-based center. The sample included adults 18 years and older during the 1 year following an autologous BMT. Both disease-free patients and those who relapsed with 1-year of follow-up data available were included. Of 59 eligible patients, 58 (98%) responded to the questionnaire. Patients completed a telephone questionnaire administered by a nurse specialist in the field of BMT approximately every 90 days. At the time of initial contact on day +90, the mean quality of life was 7.8 (range, 1 to 10) on a scale of 1 to 10, with 10 being the best. By the end of the first year of follow-up, the mean quality of life was 8.9 (range, 3 to 10). Seventy- eight percent of the patients were employed. Twenty-one percent lost weight during the first year, with the majority reporting voluntary weight loss. Fourteen percent reported difficulties with sexual activity. Only 5% reported difficulty with sleeping or with frequent colds. One patient felt that her appearance was worse, and none of the patients reported a poor appetite. Eighty-eight percent of surviving adult patients reported an above-average to excellent quality of life 1 year following autologous BMT. This outcome is encouraging and suggests that this procedure is not associated with long-term morbidity in the surviving adult patient.

The CARES‐SF used for prospective assessment of health‐related quality of life after stem cell transplantation

“…The mean scores on the sexual subscale were in line with other reports employing the CARES (Rusten et al, 1999;te Velde et al, 1996;Gritz et al, 2000). Problems in relation to sexuality, both with respect to interest and activity, have frequently been reported after HDC and stem cell transplantation, with percentages varying from 14 to above 30%, depending on design and methodology (Wingard et al, 1992;Chao et al, 1992;Vose et al, 1992). One prospective report concluded that pre-treatment difficulties in the sexual domains did not change significantly within the first year (Marks et al, 1997), while another demonstrated a higher frequency of problems, increasing over time in women compared with men (Syrjala et al, 1998).…”

“…We have previously published prospective reports on HRQOL assessed by the European Organisation for Research and Treatment of Cancer Core Quality of Life questionnaire (EORTC QLQ-C30) (Hjermstad et al, 1998A, 1999B) and on anxiety and depression assessed by the Hospital Anxiety and Depression Scale (HADS) in this patient population (Hjermstad et al, 1999B). Through literature searches we have identified an additional ten prospective studies which exceeded the immediate transplant period and included at least 40 patients with haematological malignancies (Syrjala et al, 1993;Meyers et al, 1994;Jenkins et al, 1994;Broers et al, 2000Broers et al, , 1998McQuellon et al, 1997;Chao et al, 1992;Baker et al, 1999;Fife et al, 2001;Tschuschke et al, 2001). The results were not consistent regarding the patients' HRQOL after stem cell transplantation, possibly due to differences in study design, outcome measures and time of follow-up.…”

“…The results were not consistent regarding the patients' HRQOL after stem cell transplantation, possibly due to differences in study design, outcome measures and time of follow-up. Nevertheless, most patients seemed to do reasonably well within the first year after transplant, although some functions were still impaired (Syrjala et al, 1993;Meyers et al, 1994;Jenkins et al, 1994;Broers et al, 2000Broers et al, , 1998McQuellon et al, 1997;Chao et al, 1992;Hjermstad et al, 1998A;1999B, A). This was first and foremost related to physical functioning (Syrjala et al, 1993;Broers et al, 2000;Hjermstad et al, 1998A;1999B;Baker et al, 1999), reduced stamina and fatigue (Syrjala et al, 1993;McQuellon et al, 1997;Baker et al, 1999), sexual problems (Chao et al, 1992), and psychological distress such as anxiety and depression (Hjermstad et al, 1999A;Broers et al, 2000;Meyers et al, 1994;McQuellon et al, 1997;Jenkins et al, 1994;Baker et al, 1999;Fife et al, 2001).…”

Body Image in Liver Transplantation Recipients

“…(33)(34)(35)(36) BI satisfaction appears to get better with a longer time after transplantation. (37)(38)(39) When BI concerns are present, women tend to have poorer BI than men after receiving heart, kidney, or skin allografts. (34,40) In addition, in women, BI is less likely to improve with transplantation.…”

Review article: stem cell transplantation for the treatment of gastrointestinal diseases – current applications and future perspectives

“…Quality-of-life studies show that patients are able to return to their daily lives within 6 to 12 months and achieve a high quality of life. 107 Because inflammatory disease does not fulfil the criteria of clearly increased mortality to justify HSCT, it seems prudent that the patient must be fully informed and ongoing results should be analysed by a safety board. Allo-SCT has a transplant-related mortality rate of 15%-30%.…”