title: Patient-reported quality of life after allogeneic hematopoietic cell transplantation or chemotherapy for acute leukemia.
abstract: When discussing treatment options for patients with acute leukemia, it is important to acknowledge the impact of allogeneic hematopoietic cell transplantation (allo-HCT) or chemotherapy on quality of life (QOL). We performed a cross-sectional questionnaire study that administered SF-36, FACT-Leukemia and EuroQOL5D to 524 acute leukemia survivors, to compare patient-reported QOL between chemotherapy and allo-HCT, and to elucidate predictors of QOL. Patients who received chemotherapy alone had a better physical QOL than those who received allo-HCT. On the other hand, the allo-HCT group reported a better mental QOL. In the comparison of QOL in the allo-HCT patients according to the presence of GVHD at survey, patients who had GVHD symptoms experienced statistically and clinically significantly worse QOL than those who did not. In the allo-HCT patients without GVHD, the physical QOL was comparable to that in the chemotherapy patients, and they experienced significantly better mental and general QOL than the chemotherapy patients. GVHD and immunosuppressive drugs at survey were strongly associated with worse QOL after allo-HCT. In the chemotherapy group, a shorter time between treatment completion and survey was significantly associated with worse QOL. Further evaluation of QOL by a longitudinal assessment with quantitative and qualitative analyses are warranted.
authors.affiliation: Department of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Kurosawa
authors.affiliation: Division of Biostatistics, Tohoku University Graduate School of Medicine, Sendai, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Yamaguchi
authors.affiliation: Division of Hematology, Keio University School of Medicine, Tokyo, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Mori
authors.affiliation: Department of Hematology, Kanagawa Cancer Center, Yokohama, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Kanamori
authors.affiliation: Department of Hematology and Rheumatology, Tohoku University Graduate School of Medicine, Sendai, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Onishi
authors.affiliation: Department of Hematology, Fujita Health University, Toyoake, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Emi
authors.affiliation: Department of Hematology, Yokohama City University Medical Center, Yokohama, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Fujisawa
authors.affiliation: Department of Hematology and Oncology, JA Aichi Konan Kosei Hospital, Konan, Japan.
authors.forename: A
authors.initials: A
authors.lastname: Kohno
authors.affiliation: Department of Hematology, Chiba University Hospital, Chiba, Japan.
authors.forename: C
authors.initials: C
authors.lastname: Nakaseko
authors.affiliation: Division of Hematology, Department of Medicine, Showa University, Tokyo, Japan.
authors.forename: B
authors.initials: B
authors.lastname: Saito
authors.affiliation: Department of Hematology and Oncology, Kyoto University, Kyoto, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Kondo
authors.affiliation: Department of Hematology, Osaka City University, Osaka, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Hino
authors.affiliation: Division of Hematology, Ehime Prefectural Central Hospital, Matsuyama, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Nawa
authors.affiliation: Department of Pediatrics, Tokai University School of Medicine, Isehara, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Kato
authors.affiliation: NPO Blood Disorder Information and Support Service, Tsubasa, Tokyo, Japan.
authors.forename: A
authors.initials: A
authors.lastname: Hashimoto
authors.affiliation: Department of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Fukuda
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D064591:Allografts; D002648:Child; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000628:therapy*; D008875:Middle Aged; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000628:therapy*; D011788:Quality of Life; D057566:Self Report