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Published in: Supportive Care in Cancer 7/2007

01-07-2007 | Original Article

Factors associated with poor general health after stem-cell transplantation

Authors: Joacim Larsen, Gun Nordström, Per Ljungman, Ann Gardulf

Published in: Supportive Care in Cancer | Issue 7/2007

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Abstract

Aims

To describe functional status (FS), general health (GH) and symptom distress (SD) from admission to 1 year post-SCT and to identify medical, demographic, and/or patient-reported outcome variables associated with patient-perceived GH.

Material and methods

Forty-one patients (27 women) with a median age of 44 (18–65) years answered three questionnaires (SIP, SWED-QUAL, and SFID-SCT) from admission to 1 year post-SCT.

Results

At discharge, 59% of the patients reported poor FS and GH, and 24% reported >10 simultaneous symptoms. After 1 year post-SCT, 22% still reported poor FS, 32% poor GH, and 12% >10 simultaneous symptoms. Compared with admission, significantly larger proportions of the patients reported poor GH at discharge (20 vs 59%, p = .001), poor FS at 6 months (24 vs 59%, p = .004), and poor GH [The number of symptoms was found to be significantly associated with poor GH at discharge (OR 1.330, p = .009) and at 1 year post-SCT (OR 2.000, p = .010)]. Patients reporting “poor GH” at discharge and at 1 year post-SCT reported a median of 7 and 10 symptoms, respectively. Patients with “good GH” reported a median of three symptoms both at T1 and T4. “Tiredness”, “anxiety”, “mouth dryness”, “loss of appetite”, and “diarrhoea” were reported by a larger proportion of the patients reporting “poor GH”.

Conclusions

The results confirm that some patients who have undergone a SCT have a negatively affected life situation. The study indicates that actively asking for symptoms and applying the best treatment for symptom alleviation are among the most important measures that SCT teams can take to help the patients perceive better general health and an improved life situation.
Literature
1.
go back to reference Andrykowski MA, Bishop MM, Hahn EA, Cella DF, Beaumont JL, Brady MJ, Horowitz MM, Sobocinski KA, Rizzo JD, Wingard JR (2005) Long-term health-related quality of life, growth, and spiritual well-being after hematopoietic stem-cell transplantation. J Clin Oncol 23:599–608PubMedCrossRef Andrykowski MA, Bishop MM, Hahn EA, Cella DF, Beaumont JL, Brady MJ, Horowitz MM, Sobocinski KA, Rizzo JD, Wingard JR (2005) Long-term health-related quality of life, growth, and spiritual well-being after hematopoietic stem-cell transplantation. J Clin Oncol 23:599–608PubMedCrossRef
2.
go back to reference Bailis DS, Segall A, Chipperfield JG (2003) Two views of self-rated general health status. Soc Sci Med 56:203–217PubMedCrossRef Bailis DS, Segall A, Chipperfield JG (2003) Two views of self-rated general health status. Soc Sci Med 56:203–217PubMedCrossRef
3.
go back to reference Baker F, Wingard JR, Curbow B, Zabora J, Jodrey D, Fogarty L, Legro M (1994) Quality of life of bone marrow transplant long-term survivors. Bone Marrow Transplant 13:589–596PubMed Baker F, Wingard JR, Curbow B, Zabora J, Jodrey D, Fogarty L, Legro M (1994) Quality of life of bone marrow transplant long-term survivors. Bone Marrow Transplant 13:589–596PubMed
4.
go back to reference Baker F, Zabora J, Polland A, Wingard J (1999) Reintegration after bone marrow transplantation. Cancer Pract 7:190–197PubMedCrossRef Baker F, Zabora J, Polland A, Wingard J (1999) Reintegration after bone marrow transplantation. Cancer Pract 7:190–197PubMedCrossRef
5.
go back to reference Barsevick AM, Dudley W, Beck S, Sweeney C, Whitmer K, Nail L (2004) A randomized clinical trial of energy conservation for patients with cancer-related fatigue. Cancer 100:1302–1310PubMedCrossRef Barsevick AM, Dudley W, Beck S, Sweeney C, Whitmer K, Nail L (2004) A randomized clinical trial of energy conservation for patients with cancer-related fatigue. Cancer 100:1302–1310PubMedCrossRef
6.
go back to reference Bergner M, Bobbitt RA, Carter WB, Gilson BS (1981) The Sickness Impact Profile: development and final revision of a health status measure. Med Care 19:787–805PubMedCrossRef Bergner M, Bobbitt RA, Carter WB, Gilson BS (1981) The Sickness Impact Profile: development and final revision of a health status measure. Med Care 19:787–805PubMedCrossRef
7.
go back to reference Broers S, Kaptein AA, Le Cessie S, Fibbe W, Hengeveld MW (2000) Psychological functioning and quality of life following bone marrow transplantation: a 3-year follow-up study. J Psychosom Res 48:11–21PubMedCrossRef Broers S, Kaptein AA, Le Cessie S, Fibbe W, Hengeveld MW (2000) Psychological functioning and quality of life following bone marrow transplantation: a 3-year follow-up study. J Psychosom Res 48:11–21PubMedCrossRef
8.
go back to reference Brorsson B, Ifver J, Hays RD (1993) The Swedish Health-Related Quality of Life Survey (SWED-QUAL). Qual Life Res 2:33–45PubMedCrossRef Brorsson B, Ifver J, Hays RD (1993) The Swedish Health-Related Quality of Life Survey (SWED-QUAL). Qual Life Res 2:33–45PubMedCrossRef
9.
10.
go back to reference Coates A, Porzsolt F, Osoba D (1997) Quality of life in oncology practice: prognostic value of EORTC QLQ-C30 scores in patients with advanced malignancy. Eur J Cancer 33:1025–1030PubMedCrossRef Coates A, Porzsolt F, Osoba D (1997) Quality of life in oncology practice: prognostic value of EORTC QLQ-C30 scores in patients with advanced malignancy. Eur J Cancer 33:1025–1030PubMedCrossRef
11.
go back to reference Coleman EA, Hall-Barrow J, Coon S, Stewart CB (2003) Facilitating exercise adherence for patients with multiple myeloma. Clin J Oncol Nurs 7:529–534, 540PubMed Coleman EA, Hall-Barrow J, Coon S, Stewart CB (2003) Facilitating exercise adherence for patients with multiple myeloma. Clin J Oncol Nurs 7:529–534, 540PubMed
12.
go back to reference Courneya KS, Friedenreich CM, Sela RA, Quinney HA, Rhodes RE, Handman M (2003) The group psychotherapy and home-based physical exercise (group-hope) trial in cancer survivors: physical fitness and quality of life outcomes. Psychooncology 12:357–374PubMedCrossRef Courneya KS, Friedenreich CM, Sela RA, Quinney HA, Rhodes RE, Handman M (2003) The group psychotherapy and home-based physical exercise (group-hope) trial in cancer survivors: physical fitness and quality of life outcomes. Psychooncology 12:357–374PubMedCrossRef
13.
go back to reference Courneya KS, Keats MR, Turner AR (2000) Physical exercise and quality of life in cancer patients following high dose chemotherapy and autologous bone marrow transplantation. Psychooncology 9:127–136PubMedCrossRef Courneya KS, Keats MR, Turner AR (2000) Physical exercise and quality of life in cancer patients following high dose chemotherapy and autologous bone marrow transplantation. Psychooncology 9:127–136PubMedCrossRef
14.
go back to reference Dimeo F, Schmittel A, Fietz T, Schwartz S, Kohler P, Boning D, Thiel E (2004) Physical performance, depression, immune status and fatigue in patients with hematological malignancies after treatment. Ann Oncol 15:1237–1242PubMedCrossRef Dimeo F, Schmittel A, Fietz T, Schwartz S, Kohler P, Boning D, Thiel E (2004) Physical performance, depression, immune status and fatigue in patients with hematological malignancies after treatment. Ann Oncol 15:1237–1242PubMedCrossRef
16.
go back to reference Dimeo FC, Thomas F, Raabe-Menssen C, Propper F, Mathias M (2004) Effect of aerobic exercise and relaxation training on fatigue and physical performance of cancer patients after surgery. A randomised controlled trial. Support Care Cancer 12:774–779PubMedCrossRef Dimeo FC, Thomas F, Raabe-Menssen C, Propper F, Mathias M (2004) Effect of aerobic exercise and relaxation training on fatigue and physical performance of cancer patients after surgery. A randomised controlled trial. Support Care Cancer 12:774–779PubMedCrossRef
17.
go back to reference Dodd MJ, Miaskowski C, Paul SM (2001) Symptom clusters and their effect on the functional status of patients with cancer. Oncol Nurs Forum 28:465–470PubMed Dodd MJ, Miaskowski C, Paul SM (2001) Symptom clusters and their effect on the functional status of patients with cancer. Oncol Nurs Forum 28:465–470PubMed
18.
go back to reference Edman L, Larsen J, Hägglund H, Gardulf A (2001) Health-related quality of life, symptom distress and sense of coherence in adult survivors of allogeneic stem-cell transplantation. Eur J Cancer Care 10:124–130CrossRef Edman L, Larsen J, Hägglund H, Gardulf A (2001) Health-related quality of life, symptom distress and sense of coherence in adult survivors of allogeneic stem-cell transplantation. Eur J Cancer Care 10:124–130CrossRef
19.
go back to reference Eriksson I, Unden AL, Elofsson S (2001) Self-rated health. Comparisons between three different measures. Results from a population study. Int J Epidemiol 30:326–333PubMedCrossRef Eriksson I, Unden AL, Elofsson S (2001) Self-rated health. Comparisons between three different measures. Results from a population study. Int J Epidemiol 30:326–333PubMedCrossRef
20.
go back to reference Fayers PM, Machin D (2000) Methods for missing forms. In: Quality of life: assessment, analysis and interpretation. Wiley, Chichester, pp 236–245 Fayers PM, Machin D (2000) Methods for missing forms. In: Quality of life: assessment, analysis and interpretation. Wiley, Chichester, pp 236–245
21.
go back to reference Fayers PM, Machin D (2000) Missing data. In: Quality of life: assessment, analysis and interpretation. Wiley, Chichester, pp 224–247 Fayers PM, Machin D (2000) Missing data. In: Quality of life: assessment, analysis and interpretation. Wiley, Chichester, pp 224–247
23.
go back to reference Fife B, Huster G, Cornetta K, Kennedy V, Akard L, Broun E (2000) Longitudinal study of adaptation to the stress of bone marrow transplantation. J Clin Oncol 18:1539–1549PubMed Fife B, Huster G, Cornetta K, Kennedy V, Akard L, Broun E (2000) Longitudinal study of adaptation to the stress of bone marrow transplantation. J Clin Oncol 18:1539–1549PubMed
24.
go back to reference Gaston-Johansson F, Fall-Dickson JM, Nanda J, Ohly KV, Stillman S, Krumm S, Kennedy MJ (2000) The effectiveness of the comprehensive coping strategy program on clinical outcomes in breast cancer autologous bone marrow transplantation. Cancer Nurs 23:277–285PubMedCrossRef Gaston-Johansson F, Fall-Dickson JM, Nanda J, Ohly KV, Stillman S, Krumm S, Kennedy MJ (2000) The effectiveness of the comprehensive coping strategy program on clinical outcomes in breast cancer autologous bone marrow transplantation. Cancer Nurs 23:277–285PubMedCrossRef
25.
go back to reference Given B, Given CW, McCorkle R, Kozachik S, Cimprich B, Rahbar MH, Wojcik C (2002) Pain and fatigue management: results of a nursing randomized clinical trial. Oncol Nurs Forum 29:949–956PubMed Given B, Given CW, McCorkle R, Kozachik S, Cimprich B, Rahbar MH, Wojcik C (2002) Pain and fatigue management: results of a nursing randomized clinical trial. Oncol Nurs Forum 29:949–956PubMed
26.
go back to reference Gratwohl A, Baldomero H, Frauendorfer K, Urbano-Ispizua A (2006) EBMT activity survey 2004 and changes in disease indication over the past 15 years. Bone Marrow Transplant 37:1069–1085PubMedCrossRef Gratwohl A, Baldomero H, Frauendorfer K, Urbano-Ispizua A (2006) EBMT activity survey 2004 and changes in disease indication over the past 15 years. Bone Marrow Transplant 37:1069–1085PubMedCrossRef
27.
go back to reference Gratwohl A, Passweg J, Baldomero H, Urbano-Ispizua A (2001) Hematopoietic stem cell transplantation activity in Europe 1999. Bone Marrow Transplant 27:899–916PubMedCrossRef Gratwohl A, Passweg J, Baldomero H, Urbano-Ispizua A (2001) Hematopoietic stem cell transplantation activity in Europe 1999. Bone Marrow Transplant 27:899–916PubMedCrossRef
28.
go back to reference Hayes S, Davies PS, Parker T, Bashford J, Newman B (2004) Quality of life changes following peripheral blood stem cell transplantation and participation in a mixed-type, moderate-intensity, exercise program. Bone Marrow Transplant 33:553–558PubMedCrossRef Hayes S, Davies PS, Parker T, Bashford J, Newman B (2004) Quality of life changes following peripheral blood stem cell transplantation and participation in a mixed-type, moderate-intensity, exercise program. Bone Marrow Transplant 33:553–558PubMedCrossRef
29.
go back to reference Hosmer D, Lemesshow S (1989) Applied logistic regression. Wiley, New York Hosmer D, Lemesshow S (1989) Applied logistic regression. Wiley, New York
30.
go back to reference Jacobsen PB, Meade CD, Stein KD, Chirikos TN, Small BJ, Ruckdeschel JC (2002) Efficacy and costs of two forms of stress management training for cancer patients undergoing chemotherapy. J Clin Oncol 20:2851–2862PubMedCrossRef Jacobsen PB, Meade CD, Stein KD, Chirikos TN, Small BJ, Ruckdeschel JC (2002) Efficacy and costs of two forms of stress management training for cancer patients undergoing chemotherapy. J Clin Oncol 20:2851–2862PubMedCrossRef
31.
go back to reference Jenkins PL, Linington A, Whittaker JA (1991) A retrospective study of psychosocial morbidity in bone marrow transplant recipients. Psychosomatics 32:65–71PubMed Jenkins PL, Linington A, Whittaker JA (1991) A retrospective study of psychosocial morbidity in bone marrow transplant recipients. Psychosomatics 32:65–71PubMed
32.
go back to reference Kim SD, Kim HS (2005) Effects of a relaxation breathing exercise on fatigue in haemopoietic stem cell transplantation patients. J Clin Nurs 14:51–55PubMedCrossRef Kim SD, Kim HS (2005) Effects of a relaxation breathing exercise on fatigue in haemopoietic stem cell transplantation patients. J Clin Nurs 14:51–55PubMedCrossRef
33.
go back to reference Krishnasamy M (1995) Oral problems in advanced cancer. Eur J Cancer Care 4:173–177 Krishnasamy M (1995) Oral problems in advanced cancer. Eur J Cancer Care 4:173–177
34.
go back to reference Larsen J, Gardulf A, Nordström G, Björkstrand B, Ljungman P (1996) Health-related quality of life in women with breast cancer undergoing autologous stem-cell transplantation. Cancer Nurs 19:368–375PubMedCrossRef Larsen J, Gardulf A, Nordström G, Björkstrand B, Ljungman P (1996) Health-related quality of life in women with breast cancer undergoing autologous stem-cell transplantation. Cancer Nurs 19:368–375PubMedCrossRef
35.
go back to reference Larsen J, Nordström G, Björkstrand B, Ljungman P, Gardulf A (2003) Symptom distress, functional status and health-related quality of life prior to high-dose chemotherapy with stem-cell transplantation. Eur J Cancer Care 12:71–80CrossRef Larsen J, Nordström G, Björkstrand B, Ljungman P, Gardulf A (2003) Symptom distress, functional status and health-related quality of life prior to high-dose chemotherapy with stem-cell transplantation. Eur J Cancer Care 12:71–80CrossRef
36.
go back to reference Larsen J, Nordström G, Ljungman P, Gardulf A (2004) Symptom occurrence, symptom intensity, and symptom distress in patients undergoing high-dose chemotherapy with stem-cell transplantation. Cancer Nurs 27:55–64PubMedCrossRef Larsen J, Nordström G, Ljungman P, Gardulf A (2004) Symptom occurrence, symptom intensity, and symptom distress in patients undergoing high-dose chemotherapy with stem-cell transplantation. Cancer Nurs 27:55–64PubMedCrossRef
37.
go back to reference Lee SJ, Fairclough D, Parsons SK, Soiffer RJ, Fisher DC, Schlossman RL, Antin JH, Weeks JC (2001) Recovery after stem-cell transplantation for hematologic diseases. J Clin Oncol 19:242–252PubMed Lee SJ, Fairclough D, Parsons SK, Soiffer RJ, Fisher DC, Schlossman RL, Antin JH, Weeks JC (2001) Recovery after stem-cell transplantation for hematologic diseases. J Clin Oncol 19:242–252PubMed
38.
go back to reference Mock V, Barsevick A, Escalante C, Hinds P, O’Connor T, Piper BF, Rugo HS (2006) Cancer-related fatigue. In: Clinical practice guidelines in oncology. The National Comprehensive Cancer Network Mock V, Barsevick A, Escalante C, Hinds P, O’Connor T, Piper BF, Rugo HS (2006) Cancer-related fatigue. In: Clinical practice guidelines in oncology. The National Comprehensive Cancer Network
39.
go back to reference Oldervoll LM, Kaasa S, Knobel H, Loge JH (2003) Exercise reduces fatigue in chronic fatigued Hodgkins disease survivors-results from a pilot study. Eur J Cancer 39:57–63PubMedCrossRef Oldervoll LM, Kaasa S, Knobel H, Loge JH (2003) Exercise reduces fatigue in chronic fatigued Hodgkins disease survivors-results from a pilot study. Eur J Cancer 39:57–63PubMedCrossRef
40.
go back to reference Osoba D (1999) What has been learned from measuring health-related quality of life in clinical oncology. Eur J Cancer 35:1565–1570PubMedCrossRef Osoba D (1999) What has been learned from measuring health-related quality of life in clinical oncology. Eur J Cancer 35:1565–1570PubMedCrossRef
41.
go back to reference Pett MA (1997) Cochran’s Q tests. In: Nonparametric statistics for health care research: statistics for small samples and unusual distributions. Sage Publications, Thousand Oaks, pp 123–131 Pett MA (1997) Cochran’s Q tests. In: Nonparametric statistics for health care research: statistics for small samples and unusual distributions. Sage Publications, Thousand Oaks, pp 123–131
42.
go back to reference Saleh US, Brockopp DY (2001) Quality of life one year following bone marrow transplantation: psychometric evaluation of the quality of life in bone marrow transplant survivors tool. Oncol Nurs Forum 28:1457–1464PubMed Saleh US, Brockopp DY (2001) Quality of life one year following bone marrow transplantation: psychometric evaluation of the quality of life in bone marrow transplant survivors tool. Oncol Nurs Forum 28:1457–1464PubMed
43.
go back to reference Siegel S, Castellan NJ (1988) Friedman two-way analysis of variance by ranks. In: Nonparametric statistics for the behavioral sciences. McGraw–Hill, New York, pp 175–183 Siegel S, Castellan NJ (1988) Friedman two-way analysis of variance by ranks. In: Nonparametric statistics for the behavioral sciences. McGraw–Hill, New York, pp 175–183
44.
go back to reference Sullivan M (1988) The Sickness Impact Profile (SIP): an instrument for overall health assessment; a basic evaluation. J Drug Ther Res 13:167–169 Sullivan M (1988) The Sickness Impact Profile (SIP): an instrument for overall health assessment; a basic evaluation. J Drug Ther Res 13:167–169
45.
go back to reference Syrjala KL, Langer SL, Abrams JR, Storer BE, Martin PJ (2005) Late effects of hematopoietic cell transplantation among 10-year adult survivors compared with case-matched controls. J Clin Oncol 23:6596–6606PubMedCrossRef Syrjala KL, Langer SL, Abrams JR, Storer BE, Martin PJ (2005) Late effects of hematopoietic cell transplantation among 10-year adult survivors compared with case-matched controls. J Clin Oncol 23:6596–6606PubMedCrossRef
46.
go back to reference van Weert E, Hoekstra-Weebers J, Otter R, Postema K, Sanderman R, van der Schans C (2006) Cancer-related fatigue: predictors and effects of rehabilitation. Oncologist 11:184–196PubMedCrossRef van Weert E, Hoekstra-Weebers J, Otter R, Postema K, Sanderman R, van der Schans C (2006) Cancer-related fatigue: predictors and effects of rehabilitation. Oncologist 11:184–196PubMedCrossRef
47.
go back to reference Wilson RW, Jacobsen PB, Fields KK (2005) Pilot study of a home-based aerobic exercise program for sedentary cancer survivors treated with hematopoietic stem cell transplantation. Bone Marrow Transplant 35:721–727PubMedCrossRef Wilson RW, Jacobsen PB, Fields KK (2005) Pilot study of a home-based aerobic exercise program for sedentary cancer survivors treated with hematopoietic stem cell transplantation. Bone Marrow Transplant 35:721–727PubMedCrossRef
Metadata
Title
Factors associated with poor general health after stem-cell transplantation
Authors
Joacim Larsen
Gun Nordström
Per Ljungman
Ann Gardulf
Publication date
01-07-2007
Publisher
Springer-Verlag
Published in
Supportive Care in Cancer / Issue 7/2007
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-006-0200-0

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