Health Related Quality of Life in Adult Patients Following Hematopoietic Stem Cell Transplant

Abstract

Hematopoietic stem cell transplant (HSCT) is a curative treatment modality for a wide array of malignant and benign hematologic disorders and some solid tumors. Patients receive a conditioning regimen prior to transplant that includes a high dose of chemotherapy with or without total body irradiation. The side effects of the preparative regimen, myelosuppression, and the effects of cellular therapy can be detrimental to the patient’s health. Health-related quality of life (HRQL) has never been studied in the Lebanese population following HSCT. A longitudinal study was designed targeting 40 adult patients undergoing autologous or allogeneic HSCT. The subjects were interviewed based on the FACT-BMT tool that contains the four dimensions of quality of life (QoL): physical, social/family, emotional, and functional; in addition to a section of additional questions that address general symptoms and concerns. The answers are based on a Likert scale ranging from zero to four. Interviews were taken at points in time that are considered sensitive to the patient’s transplant trajectory: baseline (on admission), day +7 post-transplant, and the day of discharge, day 30, and day 100. All subjects reported lower means on all dimensions at day +7, and returned back to the near baseline mean on days +30 and +100. Men and women reported the same fluctuations in the means. Women reflect worse QoL than men do, especially on the physical and emotional dimensions. Although the means for allogeneic and autologous patients show the same pattern of change, however, autologous patients report a worse QoL than allogeneic at the beginning and towards day +7, yet they return to the near baseline mean on the day +100 assessment better than their allogeneic counterparts do.