title: Long-term health-related quality of life, growth, and spiritual well-being after hematopoietic stem-cell transplantation.
abstract: OBJECTIVE
  To examine health-related quality of life (HRQOL) and growth, and spiritual well-being in adult survivors of hematopoietic stem-cell transplantation (HSCT) for a malignant disease.
  
  
  METHODS
  HSCT survivors (n = 662) were recruited through the International Bone Marrow Transplant Registry/Autologous Blood and Marrow Transplant Registry and were drawn from 40 transplantation centers. HSCT survivors completed a telephone interview and a set of questionnaires a mean of 7.0 years post-HSCT (range, 1.8 to 22.6 years). Study measures included a variety of standardized measures of HRQOL and growth and spiritual well-being. An age- and sex-matched healthy comparison (HC) group (n = 158) was recruited using a peer nomination method. The HC group completed a parallel telephone interview and set of questionnaires.
  
  
  RESULTS
  Multivariate analysis of variance analyses found the HSCT survivor group reported poorer status relative to the HC group for all HRQOL outcome clusters including physical health, physical functioning, social functioning, psychological adjustment, and dyadic adjustment. In contrast, the HSCT survivor group reported more psychological and interpersonal growth. Mean effect size for the 24 outcome indices examined was 0.36 standard deviations, an effect size often considered clinically meaningful or important. The largest group differences were found for measures of general health, physical function and well-being, depression, cognitive function, and fatigue.
  
  
  CONCLUSIONS
  The experience of HSCT for a malignant disease has a wide-ranging, longstanding, and profound impact on adult recipients. Relative to healthy controls, HSCT survivors reported poorer physical, psychological, and social functioning but, conversely, more psychological and interpersonal growth, differences that appeared to persist many years after HSCT.
authors.affiliation: Department of Behavioral Science, University of Kentucky College of Medicine, Lexington, KY 40536-0086, USA. mandry@uky.edu
authors.forename: Michael A
authors.initials: MA
authors.lastname: Andrykowski
authors.forename: Michelle M
authors.initials: MM
authors.lastname: Bishop
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Hahn
authors.forename: David F
authors.initials: DF
authors.lastname: Cella
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Beaumont
authors.forename: Marianne J
authors.initials: MJ
authors.lastname: Brady
authors.forename: Mary M
authors.initials: MM
authors.lastname: Horowitz
authors.forename: Kathleen A
authors.initials: KA
authors.lastname: Sobocinski
authors.forename: J Douglas
authors.initials: JD
authors.lastname: Rizzo
authors.forename: John R
authors.initials: JR
authors.lastname: Wingard
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000523:psychology*; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D015999:Multivariate Analysis; D009369:Neoplasms / Q000628:therapy; D011788:Quality of Life; D012944:Social Support; D029181:Spirituality; D017741:Survivors / Q000523:psychology*