Long-term outcome and quality of life of patients who are alive and in complete remission more than two years after allogeneic and syngeneic stem cell transplantation

Abstract

Summary:We assessed long-term outcome in 155 patients who had undergone an allogeneic/syngeneic stem cell transplant (SCT) and were in complete remission for more than 2 years after transplant. Probability of late transplantrelated mortality was 6%, and affected only patients with chronic graft-versus-host disease (cGVHD). Thirteen percent of patients experienced relapse. Overall survival projected at 10 and 15 years was 83% and 76%, respectively. Secondary malignancies occurred in two patients, 7.5 and 11 years after SCT. Three female and four male patients parented children 19 to 84 months after SCT. Quality of life (QoL) was assessed in a cross-sectional study by the means of a 30-item questionnaire (QLQ-C30) of the EORTC. The questionnaire was sent to 127 patients remaining alive and answered by 106 patients. Seventy-three percent reported a good to very good QoL within 5 years after SCT and 78% after this time point. However, patients with cGVHD had significant impairment of physical, role and social functioning and only 60% of them were fit for work. These results from long-term survivors show that high cure rates with good to very good QoL can be achieved by allogeneic or syngeneic SCT.

Patient-reported quality of life after allogeneic hematopoietic cell transplantation or chemotherapy for acute leukemia

“…[12][13][14]19,20,46 We found that immunosuppressive therapy was another strong adverse factor, and it seemed have a larger impact on role/social QOL than GVHD. In this study, younger age was associated with a worse QOL especially in mental state, which is inconsistent with previous reports.…”

“…Many studies have been conducted to evaluate the QOL after allo-HCT. [12][13][14]19,20,[41][42][43][44][45][46][47] Several studies have compared the QOL between allo-HCT and chemotherapy groups. However, these results were conflicting, and few have controlled confounding backgrounds.…”

A single-centre assessment of long-term quality-of-life status after sibling allogeneic stem cell transplantation for chronic myeloid leukaemia in first chronic phase

“…The reliability and validity of the EORTC QLQ-C30 have been confirmed in previous studies. 11,13,20 High internal consistency and reliability has also been demonstrated in a BMT population. 6 The Leukaemia-BMT (QLQ-LEU) module was developed to evaluate the long-term sequelae of leukaemia treatments.…”

“…3 Most of the previous studies are cross-sectional in design, apply one of several available instruments and pool all patients transplanted for different diagnoses at a single centre. [4][5][6][7][8][9][10][11][12] Although marked morbidity in the first few years is evident, there is a clear trend to improved QoL in long-term survivors of transplantation. 6,8 Nonetheless, aggregated studies confirm that a minority of individuals continue to suffer from the effects of chronic graft-versus-host disease (GvHD) and sexual dysfunction.…”

Occupational status among adult survivors following allo-SCT

“…First, many studies combine results from auto-and allo-SCT patients, 18,19 which is not optimal because the quality-of-life scores 20 and RTW rates seems to differ significantly between those groups. 7,21 Second, occupational status before SCT is either unknown 8,14,17,[22][23][24] or gathered just before the SCT, 18,19,21 which is misleading because many patients at that time point are on sick leave because of consolidation treatments. Third, only those who worked before SCT are included most often in these studies.…”