Extended Follow-Up in 212 Long-Term Allogeneic Bone Marrow Transplant Survivors Issues of Quality of Life

Our purpose was to investigate longitudinally healthrelated quality of life (HRQOL) outcomes and related factors up to 2 years post-pediatric SCT. A total of 99 mothers of patients, aged 1.5-17 years, completed two standardized HRQOL questionnaires, generic and disease specific (DS), about the child, and reported on their own symptoms of depression and family function pre-SCT, 12 and 24 months post-SCT. Clinical (diagnosis, radiation), child (age) and family (maternal depression) information was also obtained. Significant improvement in physical and psychosocial HRQOL from pre-SCT to 1 or 2 years post-SCT was reported. Survivors of ALL were reported to have poorer physical and psychosocial HRQOL than survivors of solid tumors on the DS measure. Maternal depression was negatively associated with physical and psychosocial HRQOL. Maternal education (higher) at pre-SCT predicted improvements in physical domains 2 years post-SCT; mother's age (older) and child's age (younger) also predicted improvements of physical and emotional HRQOL. We conclude that survivors of pediatric SCT improved physical and psychosocial HRQOL by 1 and 2 years post-SCT. Older survivors whose mothers are younger and distressed, with lower education at SCT have compromised HRQOL compared to other survivors. This study has important implications for the care of SCT survivors and their families.

Section: Discussionsupporting

confidence: 92%

Longitudinal health-related quality of life outcomes and related factors after pediatric SCT

Barrera

Atenafu

Hancock

2009

“…As previously reported by Schmidt and colleagues, and later by Andrykowski in the review paper, younger patients may overcome BMT-related difficulties more readily than older BMT recipients. 26,56 However, when we investigated whether demographic and BMTrelated variables (e.g. age, gender, age at BMT, TBI dose) were related to patients' QOL, we found no relationships between these variables and measures of patients' QOL.…”

Section: Discussionmentioning

confidence: 90%

Quality of life in adults following bone marrow transplantation during childhood

Helder

Bakker

Heer

et al. 2003

list. BMT-related variables were obtained from medical files. Of the generic QOL measures, most results fell within the normal range of functioning, although some illness-related impairment was reported on subscales for general and work-related functioning. Compared to a reference sample of patients who had received BMT as adults, patients involved in this study scored significantly higher on the 'emotional well-being' subscale of the FACT-BMT, indicating significantly better emotional functioning. The age at BMT and total body irradiation (TBI) were not related to patients' QOL. We can conclude that at long term, having received BMT during childhood does not negatively affect the QOL of patients.

“…On the other hand, general behavioral adjustment tended to be stable or to improve by 1 year post-HSCT. 14,21,22 The area most affected appeared to be social functioning. 21,23,24 However, results of longitudinal studies indicated a return to functioning similar to that before transplant at 2 years post-HSCT.…”

Section: Study Sample (N) Resultsmentioning

confidence: 99%

Cognitive and psychosocial functioning of pediatric hematopoietic stem cell transplant patients: A prospective longitudinal study

Kupst

Penati

Debban

et al. 2002

Summary:A prospective longitudinal study of cognitive and psychosocial functioning in pediatric hematopoietic stem cell transplant (HSCT) patients was conducted on three occasions: pre-HSCT, 1 year post-HSCT, and 2 years post-HSCT. In contrast to the previous hypothesis that cognitive declines would occur as a result of HSCT treatment, it was hypothesized that (1) global cognitive functioning (IQ scores), as well as specific areas would remain stable over time; (2) pre-transplant functioning would be predictive of later functioning; and (3) age would be negatively related to cognitive functioning. Based on previous research it was further hypothesized: that (4) while declines in psychosocial functioning might be seen at 1 year, functioning would improve by 2 years. 153 children and adolescents were evaluated pre-HSCT and at 1 year, with 2 year data available for 74 children. Advances in pediatric hematopoietic stem cell transplantation (HSCT) have resulted in increased survival and greater attention to long-term effects of treatment. Mortality remains relatively high in this population, however, and accumulation of data from a sufficient number of patients who survive this treatment involves many years. As a result, our understanding of the cognitive and behavioral Correspondence: MJ Kupst,