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Qol and Patients' Care

Quality of life and outcomes in patients60 years of age after allogeneic hematopoietic cell transplantation

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Abstract

Hematopoietic cell transplantation (HCT) has become an established standard of care for many older patients with hematologic malignancies. The effect of transplantation on the quality of life (QOL) of older patients, however, has not been well studied. We thus analyzed QOL in patients 60 undergoing an allogeneic HCT compared with patients <60 years. Prospective psychometric instruments were administered to 351 patients who underwent HCT from 2003 to 2010. Psychometric data were assessed longitudinally by validated questionnaires: Functional Assessment of Cancer Therapy-Bone Marrow Transplant (FACT-BMT), Coping Inventory and the Profile of Mood State-Short Form. Patients 60 reported better social (P=0.006) and functional well-being (P=0.05) with FACT assessment, and had better total scores, (P=0.043) across all time points. When adjusted for baseline QOL scores as a covariate, social well-being remained significantly better, whereas the other scores became non-significant. With a median follow-up of 49 months, there were no significant differences in OS, relapse-free survival, relapse or chronic GVHD. This study provides further evidence that advanced age should not be a barrier in the decision to pursue allogeneic HCT. Older patients achieved comparable QOL when compared with younger patients.

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Acknowledgements

We thank the transplantation team at the Cleveland Clinic Taussig Cancer Institute for their contributions, and all our patients for their participation. We thank Navneet Majhail MD, MS for his constructive review of the manuscript.

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Correspondence to B K Hamilton.

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Hamilton, B., Rybicki, L., Dabney, J. et al. Quality of life and outcomes in patients60 years of age after allogeneic hematopoietic cell transplantation. Bone Marrow Transplant 49, 1426–1431 (2014). https://doi.org/10.1038/bmt.2014.166

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