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Predictors of health-related quality of life in patients treated with auto- and allo-SCT for hematological malignancies

Abstract

Identifying factors that predict health-related quality of life (QOL) following hematopoietic SCT, is important in estimating patients’ abilities to adjust to the consequences of their disease and treatment. As the studies that have been published on this subject are scattered, the present study aimed to systematically review prognostic factors for health-related QOL after auto- and allo-SCT in hematological malignancies. A systematic, computerized search in Medline, EMBASE, PsycINFO and the Cochrane Library was conducted from 2002 to June 2010. The methodological quality of the studies was assessed using an adaptation of Hayden's criteria list. Qualitative data synthesis was performed to determine the strength of the scientific evidence. In all, 35 studies fulfilled the selection criteria. Strong–moderate evidence was found for GVHD, conditioning regimen, being female, younger age, receiving less social support and pre-transplant psychological distress as predictors of various aspects of health-related QOL following hematopoietic SCT. The results of this review may help transplant teams in selecting patients at risk for experiencing a diminished health-related QOL following hematopoietic SCT. Follow-up treatment can be provided in order to promote QOL.

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References

  1. Gratwohl A, Baldomero H, Aljurf M, Pasquini MC, Bouzas LF, Yoshimi A et al. Hematopoietic stem cell transplantation: a global perspective. JAMA 2010; 303: 1617–1624.

    Article  CAS  Google Scholar 

  2. Curtis RE, Rowlings PA, Deeg HJ, Shriner DA, Socie G, Travis LB et al. Solid cancers after bone marrow transplantation. N Engl J Med 1997; 336: 897–904.

    Article  CAS  Google Scholar 

  3. Duell T, van Lint MT, Ljungman P, Tichelli A, Socie G, Apperley JF et al. Health and functional status of long-term survivors of bone marrow transplantation. EBMT Working Party on Late Effects and EULEP Study Group on Late Effects. European Group for Blood and Marrow Transplantation. Ann Intern Med 1997; 126: 184–192.

    Article  CAS  Google Scholar 

  4. Gratwohl A, Baldomero H, Frauendorfer K, Urbano-Ispizua A . EBMT activity survey 2004 and changes in disease indication over the past 15 years. Bone Marrow Transplant 2006; 37: 1069–1085.

    Article  CAS  Google Scholar 

  5. Lee SJ, Joffe S, Kim HT, Socie G, Gilman AL, Wingard JR et al. Physicians’ attitudes about quality-of-life issues in hematopoietic stem cell transplantation. Blood 2004; 104: 2194–2200.

    Article  CAS  Google Scholar 

  6. The World Health Organization Quality of Life assessment (WHOQOL): position paper from the World Health Organization. Soc Sci Med 1995; 41: 1403–1409.

  7. Schipper H, Clinch J, Olweny C . Quality of life studies: definitions and conceptual issues. In: Spilker B (ed). Quality of Life and Pharmacoeconomics in Clinical Trials, 2nd edn. Lippincott-Raven Publishers: Philadelphia, 1996, pp 11–23.

    Google Scholar 

  8. Mosher CE, Redd WH, Rini CM, Burkhalter JE, DuHamel KN . Physical, psychological, and social sequelae following hematopoietic stem cell transplantation: a review of the literature. Psychooncology 2009; 18: 113–127.

    Article  Google Scholar 

  9. Pidala J, Anasetti C, Jim H . Quality of life after allogeneic hematopoietic cell transplantation. Blood 2009; 114: 7–19.

    Article  CAS  Google Scholar 

  10. Pidala J, Anasetti C, Jim H . Health-related quality of life following haematopoietic cell transplantation: patient education, evaluation and intervention. Br J Haematol 2010; 148: 373–385.

    Article  Google Scholar 

  11. Lee SJ, Vogelsang G, Flowers MED . Chronic graft-versus-host disease. Biol Blood Marrow Transplant 2003; 9: 215–233.

    Article  CAS  Google Scholar 

  12. Hayden JA, Cote P, Bombardier C . Evaluation of the quality of prognosis studies in systematic reviews. Ann Intern Med 2006; 144: 427–437.

    Article  Google Scholar 

  13. Licht-Strunk E, van der Windt DAWM, van Marwijk HWJ, de Haan M, Beekman ATF . The prognosis of depression in older patients in general practice and the community. A systematic review. Fam Pract 2007; 24: 168–180.

    Article  Google Scholar 

  14. Altmaier EM, Ewell M, McQuellon R, Geller N, Carter SL, Henslee-Downey J et al. The effect of unrelated donor marrow transplantation on health-related quality of life: a report of the unrelated donor marrow transplantation trial (T-cell depletion trial). Biol Blood Marrow Transplant 2006; 12: 648–655.

    Article  Google Scholar 

  15. Anderson KO, Giralt SA, Mendoza TR, Brown JO, Neumann JL, Mobley GM et al. Symptom burden in patients undergoing autologous stem-cell transplantation. Bone Marrow Transplant 2007; 39: 759–766.

    Article  CAS  Google Scholar 

  16. Andersson I, Ahlberg K, Stockelberg D, Brune M, Persson LO . Health-related quality of life in patients undergoing allogeneic stem cell transplantation after reduced intensity conditioning versus myeloablative conditioning. Cancer Nurs 2009; 32: 325–334.

    Article  Google Scholar 

  17. Andorsky DJ, Loberiza FR, Lee SJ . Pre-transplantation physical and mental functioning is strongly associated with self-reported recovery from stem cell transplantation. Bone Marrow Transplant 2006; 37: 889–895.

    Article  CAS  Google Scholar 

  18. Wells KJ, Booth-Jones M, Jacobsen PB . Do coping and social support predict depression and anxiety in patients undergoing hematopoietic stem cell transplantation? J Psychosoc Oncol 2009; 27: 297–315.

    Article  Google Scholar 

  19. Fann JR, Alfano CM, Roth-Roemer S, Katon WJ, Syrjala KL . Impact of delirium on cognition, distress, and health-related quality of life after hematopoietic stem-cell transplantation. J Clin Oncol 2007; 25: 1223–1231.

    Article  Google Scholar 

  20. Bevans MF, Marden S, Leidy NK, Soeken K, Cusack G, Rivera P et al. Health-related quality of life in patients receiving reduced-intensity conditioning allogeneic hematopoietic stem cell transplantation. Bone Marrow Transplant 2006; 38: 101–109.

    Article  CAS  Google Scholar 

  21. Chang G, Orav EJ, McNamara TK, Tong MY, Antin JH . Psychosocial function after hematopoietic stem cell transplantation. Psychosomatics 2005; 46: 34–40.

    Article  Google Scholar 

  22. Diez-Campelo M, Perez-Simon JA, Gonzalez-Porras JR, Garcia-Cecilia JM, Salinero M, Caballero MD et al. Quality of life assessment in patients undergoing reduced intensity conditioning allogeneic as compared to autologous transplantation: results of a prospective study. Bone Marrow Transplant 2004; 34: 729–738.

    Article  CAS  Google Scholar 

  23. Larsen J, Nordstrom G, Ljungman P, Gardulf A . Symptom occurrence, symptom intensity, and symptom distress in patients undergoing high-dose chemotherapy with stem-cell transplantation. Cancer Nurs 2004; 27: 55–64.

    Article  Google Scholar 

  24. Larsen J, Nordstrom G, Ljungman P, Gardulf A . Factors associated with poor general health after stem-cell transplantation. Support Care Cancer 2007; 15: 849–857.

    Article  Google Scholar 

  25. Friedman MA, Fernandez M, Wefel JS, Myszka KA, Champlin RE, Meyers CA . Course of cognitive decline in hematopoietic stem cell transplantation: a within-subjects design. Arch Clin Neuropsychol 2009; 24: 689–698.

    Article  Google Scholar 

  26. Grulke N, Bailer H, Kachele H, Bunjes D . Psychological distress of patients undergoing intensified conditioning with radioimmunotherapy prior to allogeneic stem cell transplantation. Bone Marrow Transplant 2005; 35: 1107–1111.

    Article  CAS  Google Scholar 

  27. Harder H, van Gool AR, Duivenvoorden HJ, Cornelissen JJ, Eijkenboom WMH, Barge RMY et al. Case-referent comparison of cognitive functions in patients receiving haematopoietic stem-cell transplantation for haematological malignancies: two-year follow-up results. Eur J Cancer 2007; 43: 2052–2059.

    Article  Google Scholar 

  28. Harder H, Duivenvoorden HJ, van Gool AR, Cornelissen JJ, van den Bent MJ . Neurocognitive functions and quality of life in haematological patients receiving haematopoietic stem cell grafts: a one-year follow-up pilot study. J Clin Exp Neuropsychol 2006; 28: 283–293.

    Article  Google Scholar 

  29. Hochhausen N, Altmaier EM, McQuellon R, Davies SM, Papadopolous E, Carter S et al. Social support, optimism, and self-efficacy predict physical and emotional well-being after bone marrow transplantation. J Psychosoc Oncol 2007; 25: 87–101.

    Article  Google Scholar 

  30. Humphreys CT, Tallman B, Altmaier EM, Barnette V . Sexual functioning in patients undergoing bone marrow transplantation: a longitudinal study. Bone Marrow Transplant 2007; 39: 491–496.

    Article  CAS  Google Scholar 

  31. Basinski JR, Alfano CM, Katon WJ, Syrjala KL, Fann JR . Impact of delirium on distress, health-related quality of life, and cognition 6 months and 1 year after hematopoietic cell transplant. Biol Blood Marrow Transplant 2010; 16: 824–831.

    Article  Google Scholar 

  32. Langer SL, Brown JD, Syrjala KL . Intrapersonal and interpersonal consequences of protective buffering among cancer patients and caregivers. Cancer 2009; 115 (18 Suppl): 4311–4325.

    Article  Google Scholar 

  33. Lee SJ, Loberiza FR, Antin JH, Kirkpatrick T, Prokop L, Alyea EP et al. Routine screening for psychosocial distress following hematopoietic stem cell transplantation. Bone Marrow Transplant 2005; 35: 77–83.

    Article  CAS  Google Scholar 

  34. Syrjala KL, Langer SL, Abrams JR, Storer B, Sanders JE, Flowers MED et al. Recovery and long-term function after hematopoietic cell transplantation for leukemia or lymphoma. JAMA 2004; 291: 2335–2343.

    Article  CAS  Google Scholar 

  35. Jenks Kettmann JD, Altmaier EM . Social support and depression among bone marrow transplant patients. J Health Psychol 2008; 13: 39–46.

    Article  Google Scholar 

  36. Lee SJ, Kim HT, Ho VT, Cutler C, Alyea EP, Soiffer RJ et al. Quality of life associated with acute and chronic graft-versus-host disease. Bone Marrow Transplant 2006; 38: 305–310.

    Article  CAS  Google Scholar 

  37. Bevans MF, Mitchell SA, Marden S . The symptom experience in the first 100 days following allogeneic hematopoietic stem cell transplantation (HSCT). Support Care Cancer 2008; 16: 1243–1254.

    Article  Google Scholar 

  38. Fann JR, Roth-Roemer S, Burington BE, Katon WJ, Syrjala KL . Delirium in patients undergoing hematopoietic stem cell transplantation. Cancer 2002; 95: 1971–1981.

    Article  Google Scholar 

  39. Prieto JM, Atala J, Blanch J, Carreras E, Rovira M, Cirera E et al. Patient-rated emotional and physical functioning among hematologic cancer patients during hospitalization for stem-cell transplantation. Bone Marrow Transplant 2005; 35: 307–314.

    Article  CAS  Google Scholar 

  40. Rischer J, Scherwath A, Zander AR, Koch U, Schulz-Kindermann F . Sleep disturbances and emotional distress in the acute course of hematopoietic stem cell transplantation. Bone Marrow Transplant 2009; 44: 121–128.

    Article  CAS  Google Scholar 

  41. Prieto JM, Blanch J, Atala J, Carreras E, Rovira M, Cirera E et al. Clinical factors associated with fatigue in haematologic cancer patients receiving stem-cell transplantation. Eur J Cancer 2006; 42: 1749–1755.

    Article  Google Scholar 

  42. Schulz-Kindermann F, Hennings U, Ramm G, Zander AR, Hasenbring M . The role of biomedical and psychosocial factors for the prediction of pain and distress in patients undergoing high-dose therapy and BMT/PBSCT. Bone Marrow Transplant 2002; 29: 341–351.

    Article  CAS  Google Scholar 

  43. Kirchhoff AC, Leisenring W, Syrjala KL . Prospective predictors of return to work in the 5 years after hematopoietic cell transplantation. J Cancer Surviv 2010; 4: 33–44.

    Article  Google Scholar 

  44. Sherman AC, Simonton S, Latif U, Plante TG, Anaissie EJ . Changes in quality-of-life and psychosocial adjustment among multiple myeloma patients treated with high-dose melphalan and autologous stem cell transplantation. Biol Blood Marrow Transplant 2009; 15: 12–20.

    Article  Google Scholar 

  45. Sherman AC, Plante TG, Simonton S, Latif U, Anaissie EJ . Prospective study of religious coping among patients undergoing autologous stem cell transplantation. J Behav Med 2009; 32: 118–128.

    Article  Google Scholar 

  46. Schulz-Kindermann F, Mehnert A, Scherwath A, Schirmer L, Schleimer B, Zander AR et al. Cognitive function in the acute course of allogeneic hematopoietic stem cell transplantation for hematological malignancies. Bone Marrow Transplant 2007; 39: 789–799.

    Article  CAS  Google Scholar 

  47. Wong FL, Francisco L, Togawa K, Bosworth A, Gonzales M, Hanby C et al. Long-term recovery after hematopoietic cell transplantation: predictors of quality of life concerns. Blood 2010; 115: 2508–2519.

    Article  CAS  Google Scholar 

  48. Mielcarek M, Martin PJ, Leisenring W, Flowers MED, Maloney DG, Sandmaier BM et al. Graft-versus-host disease after nonmyeloablative versus conventional hematopoietic stem cell transplantation. Blood 2003; 102: 756–762.

    Article  CAS  Google Scholar 

  49. Hill J, Holcombe C, Clark L, Boothby M, Hincks A, Fisher J et al. Predictors of onset of depression and anxiety in the year after diagnosis of breast cancer. Psychol Med 2011; 41: 1429–1436.

    Article  CAS  Google Scholar 

  50. Nordin K, Berglund G, Glimelius B, Sjoden PO . Predicting anxiety and depression among cancer patients: a clinical model. Eur J Cancer 2001; 37: 376–384.

    Article  CAS  Google Scholar 

  51. Kenne Sarenmalm E, Ohlen J, Oden A, Gaston-Johansson F . Experience and predictors of symptoms, distress and health-related quality of life over time in postmenopausal women with recurrent breast cancer. Psychooncology 2008; 17: 497–505.

    Article  Google Scholar 

  52. Lo C, Zimmermann C, Rydall A, Walsh A, Jones JM, Moore MJ et al. Longitudinal study of depressive symptoms in patients with metastatic gastrointestinal and lung cancer. J Clin Oncol 2010; 28: 3084–3089.

    Article  Google Scholar 

  53. Miaskowski C . Gender differences in pain, fatigue, and depression in patients with cancer. J Natl Cancer Inst Monogr 2004; 32): 139–143.

    Article  Google Scholar 

  54. Sorror ML, Maris MB, Storb R, Baron F, Sandmaier BM, Maloney DG et al. Hematopoietic cell transplantation (HCT)-specific comorbidity index: a new tool for risk assessment before allogeneic HCT. Blood 2005; 106: 2912–2919.

    Article  CAS  Google Scholar 

  55. Glucksberg H, Storb R, Fefer A, Buckner CD, Neiman PE, Clift RA et al. Clinical manifestations of graft-versus-host disease in human recipients of marrow from HL-A-matched sibling donors. Transplantation 1974; 18: 295–304.

    Article  CAS  Google Scholar 

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Acknowledgements

We gratefully acknowledge the help of Marijke Mol in the development of our search strategy.

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Correspondence to A M J Braamse.

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Braamse, A., Gerrits, M., van Meijel, B. et al. Predictors of health-related quality of life in patients treated with auto- and allo-SCT for hematological malignancies. Bone Marrow Transplant 47, 757–769 (2012). https://doi.org/10.1038/bmt.2011.130

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