title: Long-term recovery after hematopoietic cell transplantation: predictors of quality-of-life concerns.
abstract: This prospective longitudinal study examined the quality of life (QOL) after hematopoietic cell transplantation (HCT) and identified risk factors of poor QOL in 312 adult autologous and allogeneic HCT patients. Physical, psychological, social, and spiritual well-being was assessed before HCT, 6 months, and 1, 2, and 3 years after HCT. For all HCT patients, physical QOL was stable from before to after HCT (P > .05); psychologic (P < .001), social (P < .001), and spiritual (P = .03) QOL improved at 6 months. Study noncompleters (because of illness or death) had worse QOL. Allogeneic patients reported worse physical and psychologic well-being (P < .05). Older patients reported worse physical but better social well-being regardless of HCT type (P < .05). Two or more domains were affected by race/ethnicity, household income, and education in autologous patients, and by body mass index (BMI), decline in BMI, primary diagnosis, and chronic graft-versus-host disease (GVHD) in allogeneic patients (P < .05). At 3 years, 74% of HCT patients were employed full or part time. Older autologous patients with lower pre-HCT income were less likely to work (P < .05); allogeneic patients with chronic GVHD were less likely to work (P = .002). Multidisciplinary efforts to identify and support vulnerable subgroups after HCT need to be developed.
authors.affiliation: Population Sciences, City of Hope National Medical Center, Duarte, CA 91010-3000, USA. lwong@coh.org
authors.forename: F Lennie
authors.initials: FL
authors.lastname: Wong
authors.forename: Liton
authors.initials: L
authors.lastname: Francisco
authors.forename: Kayo
authors.initials: K
authors.lastname: Togawa
authors.forename: Alysia
authors.initials: A
authors.lastname: Bosworth
authors.forename: Mitzi
authors.initials: M
authors.lastname: Gonzales
authors.forename: Cara
authors.initials: C
authors.lastname: Hanby
authors.forename: Melanie
authors.initials: M
authors.lastname: Sabado
authors.forename: Marcia
authors.initials: M
authors.lastname: Grant
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Forman
authors.forename: Smita
authors.initials: S
authors.lastname: Bhatia
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D004651:Employment / Q000706:statistics & numerical data*; D005260:Female; D006086:Graft vs Host Disease / Q000453:epidemiology / Q000523:psychology / Q000534:rehabilitation; D006304:Health Status; D006402:Hematologic Diseases / Q000453:epidemiology / Q000523:psychology / Q000628:therapy; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects / Q000523:psychology* / Q000706:statistics & numerical data*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011446:Prospective Studies; D011788:Quality of Life; D012307:Risk Factors; D013997:Time Factors; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous; D055815:Young Adult