S_mnary Questionnaires assessing a range of quality of life (QOL) outcomes were completed by 200 adult bone marrow transplant (BMT) recipients from five BMT treatment centres. Respondents had undergone allogeneic (46%) or autologous BMT (54%) for a haematological malignancy and were disease free and at least 12 months post BMT (mean 43 months). Variability in post-BMT QOL was reported with deficits in physical, sexual and occupational functioning particularly likely. Allogeneic recipients reported poorer QOL than autologous recipients. Greater age at BMT, lower level of education and more advanced disease at BMT were consistent risk factors for poorer QOL. Contrary to previous research, evidence for improved functional status with the passage of time post BMT was obtained. Factors generally not associated with post-BMT QOL included disease diagnosis, dose of total body irradiation, presence of chronic graft-versus-host disease (GVHD), type of GVHD prophylaxis and extent of marrow graft match. In conclusion, while many BMT recipients reported normal QOL, the majority indicated that their QOL was compromised relative to premorbid status. Prospective, longitudinal research will be necessary to further identify risk factors for poor post-BMT QOL and identify the temporal trajectory of post-BMT QOL.

Summary:endpoint following BMT. QOL is a multidimensional concept incorporating aspects of an individual's physical health, personal, cognitive, and occupational functioning, While problems with sleep and energy level (ie fatigue) are commonly reported during recovery from bone sociability, and feelings of personal distress and wellbeing. 1-2 A number of excellent reports investigating one marrow transplantation (BMT), little in-depth information regarding these two problem areas in BMT or more dimensions of QOL in adult BMT recipients have appeared in recent years. [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] In general, these studies sugpatients is available. Using both questionnaire and telephone interview methods, information regarding curgest that while many BMT recipients evidence a relatively normal QOL following BMT, significant numbers of adult rent sleep and energy level problems was obtained from 172 adult BMT survivors drawn from five different BMT recipients report deficits in one or more QOL domains. These deficits span a range of QOL domains and BMT treatment centers. Respondents were a mean of 43.5 months post-BMT at the time of the initial assesscan persist for years following BMT.Sleep problems and problems with fatigue, reduced ment. Similar questionnaire data was obtained from 137 respondents (80%) at a follow-up assessment 18 months energy level, or loss of stamina or strength are two areas of QOL deficit which have been identified as significant after the initial assessment. Results suggested that half to two-thirds of disease-free BMT recipients experience concerns following BMT. In a study of 125 adult long-term survivors (6-18 years) of BMT, fatigue (56% of sample) problems with regard to current energy level or sleep quality. While for the majority of patients these proband sleep disturbance (43%) were two of the three most frequently reported current physical problems. 8 Greater age lems were rated as mild, 15-20% of BMT recipients showed moderate to severe problems in these areas with at BMT was significantly associated with greater current fatigue. In a study of 135 adult BMT recipients (6-149 corresponding decrements in quality of life. Furthermore, both cross-sectional and longitudinal analyses months post-BMT), among 18 life domains rated, 'strength' was the domain with which patients were least satisfied.7 suggested that problems in these areas did not simply abate with time. Only low to moderate correlations were In another study, 23% of 162 adult long-term survivors (1 to 13 years post-BMT) of allogenic BMT reported 'variobtained between indices of sleep and energy problems and measures of anxious and depressed mood. Finally, able' or 'poor' sleeping habits. 14 Similarly, 27% of 59 adult autologous BMT recipients reported poor or variable sleep the presence of current sleep problems was associated with older age at BMT, receipt of TBI during pre-BMT habits 1 year following BMT. 9 Syrjala et al 15 reported that 27% of 31 patients 1 year post-allogeneic BMT scored in co...