Symptoms and quality of life in diverse patients undergoing hematopoietic stem cell transplantation.
BACKGROUND
Symptoms and quality of life (QOL) are critically important in hematopoietic stem cell transplantation (HSCT). However, few studies have examined these factors by transplant type among diverse cultures.


OBJECTIVE
To identify and compare QOL and symptom severity and prevalence by transplant type in a diverse population having HSCT.


METHODS
The M. D. Anderson Symptom Inventory Blood and Marrow Transplantation (MDASI-BMT) module measured symptom severity and its impact. The Functional Assessment of Cancer Therapy-Bone Marrow Transplant (FACT-BMT) measured QOL.


RESULTS
Symptom data were collected from 164 patients at eight points (pretransplant to 100 days post-transplant) and QOL data at four times. Over time, symptom severity was significantly correlated with QOL and patients who had allogeneic transplants with myeloablative regimens showed more severe sleep disturbance and poorer QOL than patients having autologous transplants. Male patients reported less fatigue than female patients. However, ethnicity was not significant. Patients whose functional status was good had fewer of the five worst symptoms and higher QOL than patients with a poor functional status. Patients with acute graft-versus-host disease had more severe symptoms than those who did not.


CONCLUSIONS
Type of transplant and preparative regimen are the most important aspects to consider when managing symptoms and QOL. This information is important for providing anticipatory guidance and support needed during the transplantation experience, to explore in future research the mechanisms involved in symptoms after HSCT, and to develop additional effective interventions.
The University of Nebraska Medical Center, College of Nursing, Omaha, NE, USA. mzcohen@unmc.edu
Marlene Z
MZ
Cohen
Cathy L
CL
Rozmus
Tito R
TR
Mendoza
Nikhil S
NS
Padhye
Joyce
J
Neumann
Ibrahima
I
Gning
Ana
A
Aleman
Sergio
S
Giralt
Charles S
CS
Cleeland
D000328:Adult; D000368:Aged; D003469:Culture; D005006:Ethnicity; D005260:Female; D006086:Graft vs Host Disease / Q000453:epidemiology; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects* / Q000523:psychology*; D006801:Humans; D007802:Language; D016014:Linear Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000628:therapy*; D011787:Quality of Health Care; D011788:Quality of Life; D012737:Sex Factors; D012959:Socioeconomic Factors; D055815:Young Adult