Symptoms and quality of life in diverse patients undergoing hematopoietic stem cell transplantation

Marlene Z Cohen, Cathy L Rozmus, Tito R Mendoza, Nikhil S Padhye, Joyce Neumann, Ibrahima Gning, Ana Aleman, Sergio Giralt, Charles S Cleeland, Marlene Z Cohen, Cathy L Rozmus, Tito R Mendoza, Nikhil S Padhye, Joyce Neumann, Ibrahima Gning, Ana Aleman, Sergio Giralt, Charles S Cleeland

Abstract

Context: Symptoms and quality of life (QOL) are critically important in hematopoietic stem cell transplantation (HSCT). However, few studies have examined these factors by transplant type among diverse cultures.

Objectives: To identify and compare QOL and symptom severity and prevalence by transplant type in a diverse population having HSCT.

Methods: The M. D. Anderson Symptom Inventory Blood and Marrow Transplantation (MDASI-BMT) module measured symptom severity and its impact. The Functional Assessment of Cancer Therapy-Bone Marrow Transplant (FACT-BMT) measured QOL.

Results: Symptom data were collected from 164 patients at eight points (pretransplant to 100 days post-transplant) and QOL data at four times. Over time, symptom severity was significantly correlated with QOL and patients who had allogeneic transplants with myeloablative regimens showed more severe sleep disturbance and poorer QOL than patients having autologous transplants. Male patients reported less fatigue than female patients. However, ethnicity was not significant. Patients whose functional status was good had fewer of the five worst symptoms and higher QOL than patients with a poor functional status. Patients with acute graft-versus-host disease had more severe symptoms than those who did not.

Conclusion: Type of transplant and preparative regimen are the most important aspects to consider when managing symptoms and QOL. This information is important for providing anticipatory guidance and support needed during the transplantation experience, to explore in future research the mechanisms involved in symptoms after HSCT, and to develop additional effective interventions.

Conflict of interest statement

Disclosures

The authors declare no conflicts of interest.

Copyright © 2012 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

Figures

Fig. 1
Fig. 1
Mean of most severe symptoms of the MDASI-BMT. MDASI-BMT = M. D. Anderson Symptom Inventory Blood and Marrow Transplantation.
Fig. 2
Fig. 2
MDASI-BMT: mean symptom severity, mean core symptoms, mean BMT subscale, and mean interference subscale. MDASI-BMT = M. D. Anderson Symptom Inventory Blood and Marrow Transplantation.
Fig. 3
Fig. 3
Mean of FACT-BMT subscales—physical well-being, social-family well-being, emotional well-being, functional well-being, and BMT subscale. FACT-BMT = Functional Assessment of Cancer Therapy-Bone Marrow Transplant.
Fig. 4
Fig. 4
Symptoms over time by transplant type.

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