title: The symptom experience in the first 100 days following allogeneic hematopoietic stem cell transplantation (HSCT).
abstract: OBJECTIVE
  Despite advances in allogeneic hematopoietic stem cell transplantation (HSCT), post-transplant complications are common, and patients' symptom experience has not been well documented.
  
  
  OBJECTIVE
  To characterize the symptom experience of adult patients pre-transplantation and days 0, 30, and 100 after allogeneic HSCT.
  
  
  METHODS
  Data from 76 participants enrolled in a prospective health-related quality of life (HRQL) study were used. Symptom occurrence, distress, and clusters were determined based on the 11 symptoms of the Symptom Distress Scale (SDS).
  
  
  RESULTS
  Participants were on average 40 years old (SD +/- 13.5). The majority (54%) received reduced intensity conditioning. Prevalent symptoms included fatigue (68%) and worry (68%) at baseline, appetite change (88%) at day 0, and fatigue at days 30 (90%) and 100 (81%). Participants reported the following symptoms as severely distressing: worry (16%) [baseline], insomnia (32%) [day 0], appetite change (22%) [day 30], and fatigue (11%) [day 100]. The total SDS score was highest at day 0 (M = 26.6 +/- 7.6) when the highest number of symptoms were reported [median = 8 (1-11)]. Symptoms formed clusters comprised of fatigue, appearance change, and worry at baseline, and fatigue, insomnia, and bowel changes at days 0 and 30. Compared to those with low symptom distress, participants with moderate/severe symptom distress reported poorer HRQL.
  
  
  CONCLUSIONS
  Allogeneic HSCT patients present for transplantation with low symptom distress yet experience multiple symptoms and high symptom distress after HSCT conditioning. Understanding the symptom experience of allogeneic HSCT patients can guide management strategies and improve HRQL.
authors.affiliation: National Institutes of Health, Clinical Center, 10 Center Drive, Room 2BO1, MSC 1151, Bethesda, MD 20892, USA.
authors.forename: Margaret F
authors.initials: MF
authors.lastname: Bevans
authors.forename: Sandra A
authors.initials: SA
authors.lastname: Mitchell
authors.forename: Susan
authors.initials: S
authors.lastname: Marden
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D000368:Aged; D016000:Cluster Analysis; D005260:Female; D006306:Health Surveys; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology / Q000601:surgery*; D015995:Prevalence; D011446:Prospective Studies; D011594:Psychometrics; D011788:Quality of Life; D013315:Stress, Psychological / Q000209:etiology*; D011795:Surveys and Questionnaires; D014184:Transplantation, Homologous; D055815:Young Adult