Health-related quality of life in adult survivors after paediatric allo-SCT

Abstract

Fifty-three adults who had received SCT as children responded to questionnaires on health-related quality of life (HRQoL) (Swedish HRQoL survey (SWED-QUAL)), sense of coherence (SOC), anxiety and depression (HAD) and a health and symptom inventory. Late effects were classified following the Common Terminology Criteria for Adverse Events (CTCAE) v. 3.0. HRQoL was below norm in 9 of 13 SWED-QUAL domains. Poorest domains (Po0.001) were satisfaction with physical health, general health, partner relations and sexual function, whereas emotional wellbeing and satisfaction with family life were on par with the norm. Older age, time elapsed post-SCT and fewer self-reported symptoms correlated with better HRQoL. Unfavourable late effect scores had no or limited impact, whereas age at SCT or TBI did not adversely affect HRQoL. Most subjects were well subjectively and objectively, whereas 24% had more complicated late effects. The median Karnofsky score was 90, 13% of subjects having scores below 80. In total, 53% reported pain, whereas 42.5% had memory and concentration problems. Anxiety and/or depression, reported by 35%, were associated with lower HRQoL and SOC ratings. Overall, 55% reported infertility and expressed difficulty with this. To conclude, childhood SCT did not negatively affect overall health for most of these adult long-term survivors, although poorer HRQoL with psychological and cognitive problems are common.

Health status of childhood leukemia survivors who received hematopoietic cell transplantation after BU or TBI: an LEA study

“…One could argue that the psychological well-being of controls was lowered due to the experience of their sibling's illness. Lö f et al 38 published results equivalent to ours when comparing QoL in 53 childhood HSCT recipients to the Swedish population norms. In their analysis, HRQoL was below Swedish norms in most domains, and exposition to TBI had no further adverse impact on it.…”

Late effects and quality of life of childhood cancer survivors: Part 1. Impact of stem cell transplantation

“…Cataract, renal dysfunction, diabetes mellitus, growth hormone deficiency, osteoporosis, delayed puberty, suspected infertility, paralysis, developmental delay, and muscle weakness seemed to be highly specific symptoms for CCS treated with SCT, with high ORs. Poor subjective QOL was observed in more than 70% of SCT-treated CCS [9,27,28], and its prevalence was significantly high as determined by the high adjusted ORs when compared with those for the general population.…”

“…The health status and extent of organ damage might affect the health-related quality of life (QOL) of long-term childhood cancer survivors (CCS) [9,10]. Many comprehensive reviews have been published in western countries (USA and Europe) on the late effects in CCS treated with SCT [11][12][13][14][15][16]; however, information on CCS treated with SCT in Asian countries including Japan is hitherto limited [17,18].…”

Late effects and healthcare needs of survivors of allogeneic stem cell transplantation: a qualitative study

“…1 Survivors report experiencing pain, memory and concentration problems, psychological distress, and problems with sexual functioning and fertility. [2][3][4] They are also at risk of disease recurrence, infections, hormonal defi ciencies, subsequent malignancy and mortality. [5][6][7] Many develop graft-versus-host disease (GVHD), a complication wherein white blood cells of transplanted tissue attack the recipient's skin, mucosa, liver and gastrointestinal tract.…”