title: Quality of life and mood of patients and family caregivers during hospitalization for hematopoietic stem cell transplantation.
abstract: BACKGROUND
  We conducted a study to investigate the impact of hospitalization for hematopoietic stem cell transplantation (HCT) on the quality of life (QOL) and mood of patients and family caregivers (FC).
  
  
  METHODS
  We conducted a longitudinal study of patients who were hospitalized for HCT and their FC. We assessed QOL (using the Functional Assessment of Cancer Therapy-Bone Marrow Transplantation) and mood (using the Hospital Anxiety and Depression Scale) at baseline (6 days before HCT), day +1, and day +8 of HCT. We administered the Medical Outcomes Study Health Survey Short Form-36 to examine FC QOL (Physical Component Scale and Mental Component Scale). To identify predictors of changes in QOL, we used multivariable linear mixed models.
  
  
  RESULTS
  We enrolled 97% of eligible patients undergoing autologous (30 patients), myeloablative (30 patients), or reduced intensity (30 patients) allogeneic HCT. Patients' QOL markedly declined (mean Functional Assessment of Cancer Therapy-Bone Marrow Transplantation score, 109.6 to 96.0; P<.0001) throughout hospitalization. The percentage of patients with depression (Hospital Anxiety and Depression Scale-Depression score of >7) more than doubled from baseline to day +8 (15.6% to 37.8%; P<.0001), whereas the percentage of patients with anxiety remained stable (22.2%; P = .8). These results remained consistent when data were stratified by HCT type. Baseline depression (β, -2.24; F, 42.2 [P<.0001]) and anxiety (β, -0.63; F, 4.4 [P =.03]) were found to independently predict worse QOL throughout hospitalization. FC QOL declined during the patient's hospitalization (physical component scale: 83.1 to 79.6 [P =.03] and mental component scale: 71.6 to 67.4 [P =.04]).
  
  
  CONCLUSIONS
  Patients undergoing HCT reported a steep deterioration in QOL and substantially worsening depression during hospitalization. Baseline anxiety and depression predicted worse QOL during hospitalization, underscoring the importance of assessing pre-HCT psychiatric morbidity.
authors.affiliation: Department of Hematology Oncology, Massachusetts General Hospital, Boston, MA.
authors.forename: Areej R
authors.initials: AR
authors.lastname: El-Jawahri
authors.forename: Lara N
authors.initials: LN
authors.lastname: Traeger
authors.forename: Kailyn
authors.initials: K
authors.lastname: Kuzmuk
authors.forename: Justin R
authors.initials: JR
authors.lastname: Eusebio
authors.forename: Harry B
authors.initials: HB
authors.lastname: Vandusen
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Shin
authors.forename: Tanya
authors.initials: T
authors.lastname: Keenan
authors.forename: Emily R
authors.initials: ER
authors.lastname: Gallagher
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Greer
authors.forename: William F
authors.initials: WF
authors.lastname: Pirl
authors.forename: Vicki A
authors.initials: VA
authors.lastname: Jackson
authors.forename: Karen K
authors.initials: KK
authors.lastname: Ballen
authors.forename: Thomas R
authors.initials: TR
authors.lastname: Spitzer
authors.forename: Timothy A
authors.initials: TA
authors.lastname: Graubert
authors.forename: Steven L
authors.initials: SL
authors.lastname: McAfee
authors.forename: Bimalangshu R
authors.initials: BR
authors.lastname: Dey
authors.forename: Yi-Bin A
authors.initials: YB
authors.lastname: Chen
authors.forename: Jennifer S
authors.initials: JS
authors.lastname: Temel
mesh_terms: D000339:Affect; D017028:Caregivers / Q000523:psychology*; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000523:psychology*; D006760:Hospitalization; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D019172:Transplantation Conditioning / Q000523:psychology*
keywords: depression; family caregivers; mood; quality of life (QOL); stem cell transplantation