liu.seSearch for publications in DiVA
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • oxford
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Early and Long-Term Follow-Up of Health-Related Quality of Life Following Allogeneic Hematopoietic Stem-Cell Transplantation
Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Medical and Health Sciences, Clinical Pharmacology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Diagnostics, Department of Clinical Pharmacology.
Östergötlands Läns Landsting, Centre for Health and Developmental Care, Regional Cancer Centre.
Department of Hematology and Coagulation, Skåne County Council, Stem Cell Center, Lund University, Lund, Sweden.
Show others and affiliations
2013 (English)Manuscript (preprint) (Other academic)
Abstract [en]

Health-related quality of life (HRQL) of 94 consecutive patients undergoing allogeneic stem cell transplantation (SCT) with myeloablative conditioning (MAC, n = 18) or reduced intensity conditioning (RIC, n = 76) was evaluated using the EORTC QLQ C-30 questionnaire at baseline and 12 times up to 3 years after SCT. Functional status and the global quality of life decreased from baseline to weeks 2 and 3, especially role and social functions. Symptoms increased significantly during the first three weeks, particularly appetite loss, nausea and vomiting, diarrhea, and fatigue. It took at least one year for HRQL to return to the baseline level. The only function that improved significantly three years after SCT was role function. MAC patients experienced worse HRQL at baseline than RIC patients, and subsequently more pain, sleep disturbance, and appetite loss in weeks 3 and 4. Patients with extensive chronic graft-versus-host disease (GvHD) experienced reduced HRQL. These results provide a good overview of patients’ symptoms and HRQL during and after SCT and indicate when they require increased support. The results also demonstrate the importance of close follow-ups during the first year after SCT in order to improve the preventive interventions, particularly regarding appetite loss and chronic GvHD.

Place, publisher, year, edition, pages
2013.
Keyword [en]
auto-SCT, health-related quality of life, multiple myeloma, lymphoma, symptoms
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-92805OAI: oai:DiVA.org:liu-92805DiVA: diva2:622614
Available from: 2013-05-22 Created: 2013-05-22 Last updated: 2013-09-03Bibliographically approved
In thesis
1. Health-related quality of life during and after stem cell transplantation
Open this publication in new window or tab >>Health-related quality of life during and after stem cell transplantation
2013 (English)Licentiate thesis, comprehensive summary (Other academic)
Abstract [en]

Hematopoietic stem cell transplantation (HSCT) is an established treatment for a variety of malignant diseases, as well as a small proportion of non-malignant disorders. The treatment before the HSCT (called conditioning) can be either myeloablative (MAC) or given with reduced intensity (RIC). MAC is associated with high toxicity due to high doses of chemotherapy with or without total body irradiation (TBI), and is used in both autologous and allogeneic HSCT. In autologous HSCT the patient is the donor, and in allogeneic HSCT the donor is a sibling or an unrelated donor. RIC regimens are associated with reduced toxicity and are only for patients undergoing allogeneic HSCT. Both autologous and allogeneic HSCT have a strong effect on the patients’ health-related quality of life (HRQL). The two studies in this thesis were initiated when RIC was introduced at a hematological department in south-east Sweden in 2001. The overall purpose was to evaluate HRQL in patients undergoing HSCT. The studies covered the whole inpatient period and the following three years in order to have a comprehensive assessment of the patients’ HRQL over time. HRQL was assessed 13 times from baseline up to three years after HSCT with the instrument EORTC QLQ-C-30. The instrument consists of 30 items divided into three major domains: functional status, symptom status, and global health/QoL. Almost all functional scales, global health status/QoL, symptom scales and single items were significantly affected in the two studies during the first two to three weeks from baseline. The symptoms that patients estimated to be the most severe in the studies were nausea and vomiting, loss of appetite, fatigue, and diarrhea. Two months after HSCT nearly all functional scales, global health status/QoL, symptom scales and single items in Study I had returned to the same value as at baseline in patients undergoing autologous HSCT. It took up to two years for patients undergoing allogeneic HSCT in Study II to return to the same value as at baseline. For patients in Study I, role-, emotional-, and social function, fatigue and dyspnea had significantly improved at the 3-year follow-up compared to baseline, whereas role function was the only function that had improved in Study II. Patients with lymphoma in Study I experienced significantly worse HRQL in week 2 and appetite loss at month 2 than patients with multiple myeloma (MM). Patients treated with MAC in Study II had significantly worse fatigue and nausea and vomiting at baseline and pain, sleep disturbance, appetite loss and diarrhea at weeks 3 and 4 than patients treated with RIC. Patients with extensive chronic Graft versus Host Disease (GvHD) in Study II reported significantly impaired physical function, role function, and global health status/QoL than patients with limited or no chronic GvHD. These results provide a good overview of patients’ symptoms and HRQL during and after HSCT and indicate when they require increased support from healthcare professionals. The results also demonstrate the importance of close follow-ups during the first year after HSCT in order to improve preventive interventions. The quick recovery of patients in Study I suggests that the extensive treatment is well tolerated.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2013. 50 p.
Series
Linköping Studies in Health Sciences. Thesis, ISSN 1100-6013 ; 125
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-92806 (URN)978-91-7519-670-1 (ISBN)
Presentation
2013-05-31, Almen, ingång 65, Campus US, Linköpings universitet, Linköping, 13:15 (Swedish)
Supervisors
Available from: 2013-05-22 Created: 2013-05-22 Last updated: 2013-05-22Bibliographically approved

Open Access in DiVA

No full text

Authority records BETA

Lotfi, KouroshFomichov, VictoriaBörjeson, Sussanne

Search in DiVA

By author/editor
Lotfi, KouroshFomichov, VictoriaBörjeson, Sussanne
By organisation
Nursing ScienceFaculty of Health SciencesClinical PharmacologyDepartment of Clinical PharmacologyRegional Cancer CentreDepartment of Oncology UHL
Medical and Health Sciences

Search outside of DiVA

GoogleGoogle Scholar

urn-nbn

Altmetric score

urn-nbn
Total: 132 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • oxford
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf