Health-related quality of life in patients receiving reduced-intensity conditioning allogeneic hematopoietic stem cell transplantation

Abstract

Reduced-intensity conditioning allogeneic HSCT (RIC) has less regimen-related morbidity and mortality than myeloablative allogeneic HSCT (MT) offering allogeneic transplantation to patients otherwise excluded. Whether these advantages improve health-related quality of life (HRQL) is unknown. We examined the HRQL effects of RIC and MT in patients with hematological diseases pre-transplant (baseline), days 0, 30 100, 1 and 2 years following HSCT. HRQL was measured using the Short Form-36 Health Survey and the Functional Assessment of Cancer Therapy -General and BMT. Data were analyzed using mixed linear modeling adjusting for baseline HRQL differences. Patients (RIC ¼ 41, MT ¼ 35) were predominately male (67%), in remission/stable disease (65%) with an Eastern Cooperative Oncology Group status p1 (97%). HRQL progressively improved (Po0.01) in both groups with higher scores at day 100 compared to days 0 and 30; there was no difference between groups during early recovery. At 2 years, all survivors (n ¼ 43) reported HRQL similar or better than baseline. Results suggest RIC and MT patients experience a similar pattern of HRQL improvement during early recovery. Two-year survivors report a return to baseline or better in HRQL by day 100, with the exception of physical health in MT patients.

Having a sibling as donor: Patients' experiences immediately before allogeneic hematopoietic stem cell transplantation

“…The main factors associated with reduced QoL over time were significant infections, female gender and transplantation with stem cells from a sibling donor. The results of deteriorations in overall QoL and physical well-being from before until 100 days after HSCT is not surprising and in agreement with other studies (Bevans et al, 2006;Lee et al, 2006;McQuellon et al, 1998). The deteriorations found in physical well-being and social well-being from before until one year after HSCT agree with the results of other studies (Bevans et al, 2006;Lee et al, 2006;SchulzKindermann et al, 2007).…”

“…The results of deteriorations in overall QoL and physical well-being from before until 100 days after HSCT is not surprising and in agreement with other studies (Bevans et al, 2006;Lee et al, 2006;McQuellon et al, 1998). The deteriorations found in physical well-being and social well-being from before until one year after HSCT agree with the results of other studies (Bevans et al, 2006;Lee et al, 2006;SchulzKindermann et al, 2007). However, the data conflict and yet other studies show improvements or no change in physical and social well-being (Bush et al, 2000;McQuellon et al, 1998;Pidala et al, 2009).…”

“…Emotional well-being improved over time for the patients in Study I, confirming the findings of earlier studies (Bevans et al, 2006;McQuellon et al, 1998). A likely explanation for this improvement is that patients are anxious about dying before the transplantation and afterwards are relieved to have survived the treatment.…”

“…Most studies show that overall QoL deteriorates immediately after transplantation and stabilises or improves after three months (Bevans et al, 2006;Lee et al, 2006;McQuellon et al, 1998). Emotional well-being has been reported to be most impaired before and immediately after HSCT, but to improve quickly after the transplantation (Bevans et al, 2006;McQuellon et al, 1998).…”

“…Emotional well-being has been reported to be most impaired before and immediately after HSCT, but to improve quickly after the transplantation (Bevans et al, 2006;McQuellon et al, 1998). There are conflicting data regarding changes in physical and social well-being (Bevans et al, 2006;Lee et al, 2006;McQuellon et al, 1998).…”