title: Quality of life in patients surviving at least 12 months following high dose chemotherapy with autologous bone marrow support.
abstract: BACKGROUND
  Over the past decade, high dose chemotherapy with autologous bone marrow (HDC-ABMT) support has been used increasingly in the treatment of patients with breast cancer. In evaluating the results of HDC-ABMT in patients with breast cancer, an assessment of quality of life can add to the traditional endpoints (toxicity, and disease-free and overall survival) that are routinely assessed in clinical trials.
  
  
  OBJECTIVE
  This study evaluated the quality of life (QOL) of breast cancer patients who had survived 1 or more years following high dose chemotherapy with autologous bone marrow transplant (HDC-ABMT) support.
  
  
  METHODS
  Eighty-two patients who had undergone HDC-ABMT were surveyed by written questionnaire and follow-up telephone interview at least 1 year following HDC-ABMT. Patients were asked to complete the Functional Living Index-Cancer (FLIC), the Symptom Distress Scale (SDS), and a survey of sexual function developed as part of the study.
  
  
  RESULTS
  The mean FLIC score among all patients was 130 +/- 19.1 (possible range 22-154). FLIC scores were significantly lower in patients with evidence of recurrent disease than in patients who were free of disease. The most commonly reported symptoms after HDC-ABMT were insomnia, fatigue, and pain. Sexual interest and sexual activity were reported to be lower after participation in HDC-ABMT than prior to the procedure. The majority of patients who were employed outside the home prior to HDC-ABMT returned to work with a median time away from work of 48 weeks.
  
  
  CONCLUSIONS
  Patients with breast cancer who survive 1 or more years following HDC-ABMT rate their QOL at a relatively high level and frequently return to work. Less than one-third of patients who were interviewed reported moderate to severe symptoms. Problems with sexual functioning were common.
  
  
  CONCLUSIONS
  Future research is needed on long-term outcomes after HDC-ABMT and on specific areas of concern, such as sexual functioning.
authors.affiliation: Department of Medicine, Duke University Medical Center, Durham, NC, USA.
authors.forename: E P
authors.initials: EP
authors.lastname: Winer
authors.forename: C
authors.initials: C
authors.lastname: Lindley
authors.forename: M
authors.initials: M
authors.lastname: Hardee
authors.forename: W T
authors.initials: WT
authors.lastname: Sawyer
authors.forename: C
authors.initials: C
authors.lastname: Brunatti
authors.forename: N A
authors.initials: NA
authors.lastname: Borstelmann
authors.forename: W
authors.initials: W
authors.lastname: Peters
mesh_terms: D000328:Adult; D016026:Bone Marrow Transplantation / Q000523:psychology*; D001943:Breast Neoplasms / Q000628:therapy*; D003131:Combined Modality Therapy; D003866:Depressive Disorder / Q000175:diagnosis / Q000523:psychology; D004305:Dose-Response Relationship, Drug; D004358:Drug Therapy / Q000523:psychology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D011788:Quality of Life; D012725:Sexual Behavior / Q000523:psychology; D011795:Surveys and Questionnaires; D013534:Survival; D013997:Time Factors; D014182:Transplantation, Autologous