Late complications and quality of life assessment for survivors receiving allogeneic hematopoietic stem cell transplantation

Support Care Cancer. 2021 Feb;29(2):975-986. doi: 10.1007/s00520-020-05572-0. Epub 2020 Jun 17.

Abstract

Purpose: The survival rates of patients undergoing allogeneic hematopoietic stem cell transplantation (HSCT) have improved. However, HSCT can induce significant long-term complications. Therefore, we investigated the late complications and risk factors for quality of life (QOL) post-HSCT.

Methods: We retrospectively analyzed 67 adult survivors over 2 years after HSCT between 2015 and 2018 at Ulsan University Hospital, Ulsan, Korea. The survey data including FACT-BMT, Hospital Anxiety and Depression Scale, and NCCN Distress Thermometer were collected as patient-reported outcomes using a tablet PC during a routine practice of survivorship clinic.

Results: The median age was 46 years. The most common symptom was fatigue (80.6%). Younger age (< 60 years), acute lymphoblastic leukemia (ALL), chronic graft-versus-host disease (GVHD), and immunosuppressant use were significantly associated with worse QOL and depression. Additionally, younger survivors (< 60 years) showed significantly more fatigue and anxiety compared with elderly survivors (≥ 60 years). Female sex was significantly associated with lower physical well-being and higher distress than male sex.

Conclusion: Younger patients (< 60 years), female, ALL, chronic GVHD, and continuous immunosuppressant use were significant risk factors for worse QOL and depression. Hence, creating a more active survivorship care plan after HSCT, specifically for these patients, is required.

Keywords: Allogeneic hematopoietic cell transplantation; FACT-BMT; Fatigue; Hospital Anxiety and Depression Scale; Late complications; Quality of life.

MeSH terms

  • Female
  • Hematopoietic Stem Cell Transplantation / adverse effects*
  • Hematopoietic Stem Cell Transplantation / methods
  • Hematopoietic Stem Cell Transplantation / mortality
  • Humans
  • Male
  • Middle Aged
  • Quality of Life / psychology*
  • Republic of Korea
  • Retrospective Studies
  • Risk Factors
  • Survival Rate
  • Survivors / statistics & numerical data*
  • Transplantation Conditioning / adverse effects*
  • Transplantation Conditioning / methods
  • Transplantation Conditioning / mortality
  • Transplantation, Homologous / adverse effects*
  • Transplantation, Homologous / methods
  • Transplantation, Homologous / mortality