Quality of life in patients randomized to receive a bone marrow or a peripheral blood allograft.
OBJECTIVE
Quality of life (QOL) is an important clinical end-point to be considered in the late follow-up of patients treated with allogeneic bone marrow (BM) or peripheral blood progenitor cell (PBPC) transplantation.


METHODS
To assess the QOL in a group of survivors of hematologic malignancies who had been enrolled in a prospective randomized trial comparing allogeneic BM with PBPC. Sixty randomized patients had been enrolled in a study comparing BM with PBPC graft during 1995-99. At the time of this QOL study, 30 were alive and 26 (13 BM and 13 PBPC) were eligible. Clinical and demographic data were collected and psychometric instruments (WHOQOL-100 and the Hospital Anxiety and Depression Scale HAD) were used. Non-parametric and univariate analyses were performed.


RESULTS
The PBPC recipients had more chronic graft-versus-host disease (p=0.03) and were on immunosuppressive treatment for a longer period (p=0.02). The WHOQOL-100 analysis demonstrated significant differences between groups with more favorable results in the BM group in the facets of Pain and Discomfort (p=0.03), Mobility (p=0.02) and Daily Living Activities (p=0.03). According to the patients' spontaneous responses, 8 individuals (6 in the PBPC group) believed that their QOL had worsened.


CONCLUSIONS
With the limitations of a small randomized study, these findings suggest a lower QOL in recipients of allogeneic PBPC than in recipients of BM grafts, probably due to the frequency and severity of chronic graft-versus-host disease. This need to be confirmed in a large international trial.
De Souza
Carmino Antonio
CA
Bone Marrow Transplantation Unit, State University of Campinas, Brazil. carmino@unicamp.br
Durães
Margareth I C
MI
Vigorito
Afonso Celso
AC
Penteado Aranha
Francisco José
FJ
Oliveira
Gislaine Barbosa
GB
De Brito Eid
Kátia A
KA
Zulli
Roberto
R
Cristina
Eliana
E
Miranda
Martins
M
Botega
Neury José
NJ
D000328:Adult; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006086:Graft vs Host Disease / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D036102:Peripheral Blood Stem Cell Transplantation / Q000009:adverse effects*; D011336:Probability; D011446:Prospective Studies; D011788:Quality of Life; D014184:Transplantation, Homologous / Q000009:adverse effects / Q000592:standards