Motor ability, function, and health-related quality of life as correlates of symptom burden in patients with sclerotic chronic graft-versus-host disease receiving imatinib mesylate

Abstract

Purpose: To explore improvement in motor ability, function, health-related quality of life (HRQOL), and symptom severity in patients with sclerotic chronic graft-versus-host disease (ScGVHD) in response to treatment as well as the relationship among changes on such measures.

Methods: This study was a secondary analysis of data from 13 individuals with severe ScGVHD enrolled in a clinical trial evaluating the efficacy of imatinib mesylate (clinicaltrials.gov identifier: NCT00702689). Self-reported, clinician-reported, and performance-based indicators of motor ability, function, HRQOL, and symptom severity were assessed at baseline and 6 months following the administration of imatinib mesylate.

Results: Participants did not show statistically significant improvement on any measures over time. Approximately one-third of patients displayed clinically significant improvement on measures of motor ability (palmar pinch strength, dominant hand, 30.8%), functioning (Manual Ability Measure-36, 41.7%), HRQOL (Short Form 36 [SF-36] Mental Component Summary, 33.3%), and symptom severity (Lee Symptom Scale, 38.5%). Improvement in cGVHD symptom burden was correlated with improvement in function (Assessment of Motor and Process Skills [AMPS] and Disabilities of the Arm, Shoulder, and Hand [DASH] scores) and HRQOL (SF-36 Physical Component Summary scores).

Conclusions: Findings suggest the potential utility of administering patient-reported and performance-based functional measures, such as the DASH and the AMPS, to patients with cGVHD. By understanding the functional consequences of ScGVHD, interdisciplinary teams of health care providers, including rehabilitation professionals, can work to improve long-term outcomes.

Keywords: Allogeneic hematopoietic stem cell transplantation; Chronic graft-versus-host disease; Functional impairment; Health-related quality of life; Sclerosis; Symptom burden.

Conflict of interest statement

Conflict of interest The authors declare that they have no conflict of interest.

Figures

Fig. 1

Histograms of AMPS ADL motor skill at baseline (a) and 6 months (b), n = 13. AMPS ADL motor skill scores are in logit units. At baseline, scores ranged from − 0.02 to 2.35. At 6 months, scores ranged from 0.18 to 2.44. There is no evidence of ceiling or floor effects at either time point (created using RStudio)

Fig. 2

Histograms of DASH scores at baseline (a) and 6 months (b), n = 12. Possible scores range from 0 to 100, with higher scores indicating greater disability. At baseline, scores ranged from 6.7 to 55. At 6 months, scores ranged from 7.8 to 71.0. There is no evidence of ceiling or floor effects for DASH scores at either time point (created using RStudio)