title: Recovery after allogeneic marrow transplantation: prospective study of predictors of long-term physical and psychosocial functioning.
abstract: No prospective data have documented the physical and psychosocial functioning of patients before and after BMT. In this study 67 allogeneic transplant patients completed standardized self-report measures pre-transplant. Survivors were re-assessed at 90 days (n = 34) and 1 year (n = 31) post-transplant. Telephone interviews established 4-year work history and performance status. Physical function was most impaired at 90 days post-transplant, with a return to pre-transplant levels of functioning by 1 year in most areas. By 2 years post-transplant, 68% of patients had returned to full-time work. Only 9% of 4-year survivors failed to return to full-time occupations. Mean levels of anxiety and depression did not change over the first year. Pre-transplant, 27% of patients reported depression and 41% reported elevated anxiety. Greater emotional distress at 1 year was predicted by pre-transplant family conflict, non-married status and development of less severe chronic GVHD. Impaired physical recovery at 1 year was predicted by more severe chronic GVHD, pre-transplant physical impairment and family conflict. The large majority of long-term survivors returned to full-time employment with normal physical and psychosocial functioning, although recovery took longer than 1 year for approximately 40%. Family relationships were important determinants of physical and emotional recovery.
authors: Fred Hutchinson Cancer Research Center, Seattle, WA 98104.
authors: K L
authors: KL
authors: Syrjala
authors: M K
authors: MK
authors: Chapko
authors: P P
authors: PP
authors: Vitaliano
authors: C
authors: C
authors: Cummings
authors: K M
authors: KM
authors: Sullivan
mesh_terms: D000328:Adult; D001007:Anxiety / Q000209:etiology; D016026:Bone Marrow Transplantation / Q000523:psychology; D002908:Chronic Disease; D003220:Conflict, Psychological; D003289:Convalescence / Q000523:psychology; D003863:Depression / Q000209:etiology; D004651:Employment; D005260:Female; D006086:Graft vs Host Disease / Q000523:psychology; D006801:Humans; D007938:Leukemia / Q000523:psychology / Q000601:surgery*; D008223:Lymphoma / Q000523:psychology / Q000601:surgery; D008297:Male; D008393:Marriage; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011581:Psychological Tests; D011788:Quality of Life; D012074:Remission Induction; D012720:Severity of Illness Index; D016896:Treatment Outcome