title: Quality of life in patients randomized to receive a bone marrow or a peripheral blood allograft.
abstract: 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.
authors.affiliation: Bone Marrow Transplantation Unit, State University of Campinas, Brazil. carmino@unicamp.br
authors.forename: Carmino Antonio
authors.initials: CA
authors.lastname: De Souza
authors.forename: Margareth I C
authors.initials: MI
authors.lastname: Durães
authors.forename: Afonso Celso
authors.initials: AC
authors.lastname: Vigorito
authors.forename: Francisco José
authors.initials: FJ
authors.lastname: Penteado Aranha
authors.forename: Gislaine Barbosa
authors.initials: GB
authors.lastname: Oliveira
authors.forename: Kátia A
authors.initials: KA
authors.lastname: De Brito Eid
authors.forename: Roberto
authors.initials: R
authors.lastname: Zulli
authors.forename: Eliana
authors.initials: E
authors.lastname: Cristina
authors.forename: Martins
authors.initials: M
authors.lastname: Miranda
authors.forename: Neury José
authors.initials: NJ
authors.lastname: Botega
mesh_terms: 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