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Supportive Care in Cancer
Published in: Supportive Care in Cancer 11/2008

01-11-2008 | Original Article

The symptom experience in the first 100 days following allogeneic hematopoietic stem cell transplantation (HSCT)

Authors: Margaret F. Bevans, Sandra A. Mitchell, Susan Marden

Published in: Supportive Care in Cancer | Issue 11/2008

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Abstract

Goals of work

Despite advances in allogeneic hematopoietic stem cell transplantation (HSCT), post-transplant complications are common, and patients’ symptom experience has not been well documented.

Purpose

To characterize the symptom experience of adult patients pre-transplantation and days 0, 30, and 100 after allogeneic HSCT.

Methods

Data from 76 participants enrolled in a prospective health-related quality of life (HRQL) study were used. Symptom occurrence, distress, and clusters were determined based on the 11 symptoms of the Symptom Distress Scale (SDS).

Results

Participants were on average 40 years old (SD ± 13.5). The majority (54%) received reduced intensity conditioning. Prevalent symptoms included fatigue (68%) and worry (68%) at baseline, appetite change (88%) at day 0, and fatigue at days 30 (90%) and 100 (81%). Participants reported the following symptoms as severely distressing: worry (16%) [baseline], insomnia (32%) [day 0], appetite change (22%) [day 30], and fatigue (11%) [day 100]. The total SDS score was highest at day 0 (M = 26.6 ± 7.6) when the highest number of symptoms were reported [median = 8 (1–11)]. Symptoms formed clusters comprised of fatigue, appearance change, and worry at baseline, and fatigue, insomnia, and bowel changes at days 0 and 30. Compared to those with low symptom distress, participants with moderate/severe symptom distress reported poorer HRQL.

Conclusion

Allogeneic HSCT patients present for transplantation with low symptom distress yet experience multiple symptoms and high symptom distress after HSCT conditioning. Understanding the symptom experience of allogeneic HSCT patients can guide management strategies and improve HRQL.
Literature
1.
Moya R, Espigado I, Parody R, Carmona M, Marquez F, De Blas JM (2006) Evaluation of readmissions in hematopoietic stem cell transplant recipients. Transplant Proc 38(8):2591–2592PubMedCrossRef
2.
Papadopoulos EB, Jakubowski AA (2006) Novel approaches in allogeneic stem cell transplantation. Curr Oncol Rep 8(5):325–336PubMedCrossRef
3.
Tabbara IA, Zimmerman K, Morgan C, Nahleh Z (2002) Allogeneic hematopoietic stem cell transplantation: complications and results. Arch Intern Med 162(14):1558–1566PubMedCrossRef
4.
Lee SJ, Loberiza FR, Antin JH, Kirkpatrick T, Prokop L, Alyea EP et al (2005) Routine screening for psychosocial distress following hematopoietic stem cell transplantation. Bone Marrow Transplant 35(1):77–83PubMedCrossRef
5.
Heinonen H, Volin L, Zevon MA, Uutela A, Barrick C, Ruutu T (2005) Stress among allogeneic bone marrow transplantation patients. Patient Educ Couns 56(1):62–71PubMedCrossRef
6.
Larsen J, Nordstrom G, Bjorkstrand B, Ljungman P, Gardulf A (2003) Symptom distress, functional status and health-related quality of life before high-dose chemotherapy with stem-cell transplantation. Eur J Cancer Care 12(1):71–80CrossRef
7.
Larsen J, Nordstrom 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(1):55–64PubMedCrossRef
8.
Fife BL, Huster GA, Cornetta KG, Kennedy VN, Akard LP, Broun ER (2000) Longitudinal study of adaptation to the stress of bone marrow transplantation. J Clin Oncol 18(7):1539–1549PubMed
9.
Hacker ED, Ferrans C, Verlen E, Ravandi F, Van Besien K, Gelms J et al (2006) Fatigue and physical activity in patients undergoing hematopoietic stem cell transplant. Oncol Nurs Forum 33(3):614–624CrossRef
10.
Hacker ED, Ferrans CE (2003) Quality of life immediately after peripheral blood stem cell transplantation. Cancer Nurs 26(4):312–322PubMedCrossRef
11.
Hjermstad MJ, Loge JH, Evensen SA, Kvaloy SO, Fayers PM, Kaasa S (1999) The course of anxiety and depression during the first year after allogeneic or autologous stem cell transplantation. Bone Marrow Transplant 24:1219–1228PubMedCrossRef
12.
Prieto JM, Blanch J, Cirera E, Gast C, Carreras E, Rovira M et al (2004) Psychometric study of quality of life instruments used during hospitalization for stem cell transplantation. J Psychosom Res 57(2):201–211PubMedCrossRef
13.
Zittoun R, Achard S, Ruszniewski M (1999) Assessment of quality of life during intensive chemotherapy or bone marrow transplantation. Psychooncology 8(1):64–73PubMedCrossRef
14.
Diez-Campelo M, Perez-Simon J, Gonzalez-Porras J, Garcia-Cecilia J, Salinero M, Caballero M et al (2004) Quality of life assessment in patients undergoing reduced intensity conditioning allogeneic as compared to autologous transplantation: results of a prospective study. Bone Marrow Transplant 34(8):729–738PubMedCrossRef
15.
Dodd M, Janson S, Facione N, Faucett J, Froelicher ES, Humphreys J et al (2001) Advancing the science of symptom management. J Adv Nurs 33(5):668–676PubMedCrossRef
16.
McClement SE, Woodgate RL, Degner L (1997) Symptom distress in adult patients with cancer. Cancer Nurs 20(4):236–243PubMedCrossRef
17.
Tishelman C, Degner LF, Mueller B (2000) Measuring symptom distress in patients with lung cancer. Cancer Nurs 23(2):82–90PubMedCrossRef
18.
Tishelman C, Degner LF, Rudman A, Bertilsson K, Bond R, Broberger E et al (2005) Symptoms in patients with lung carcinoma: distinguishing distress from intensity. Cancer 104(9):2013–2021PubMedCrossRef
19.
20.
21.
Goodell TT, Nail LM (2005) Operationalizing symptom distress in adults with cancer: a literature synthesis. Oncol Nurs Forum 32(2):E42–E47PubMedCrossRef
22.
Barsevick AM, Whitmer K, Nail LM, Beck SL, Dudley WN (2006) Symptom cluster research: conceptual, design, measurement, and analysis issues. J Pain Symptom Manage 31(1):85–95PubMedCrossRef
23.
Berger AM, Higginbotham P (2000) Correlates of fatigue during and following adjuvant breast cancer chemotherapy: a pilot study. Oncol Nurs Forum 27(9):1443–1448PubMed
24.
Dodd MJ, Miaskowski C, Paul SM (2001) Symptom clusters and their effect on the functional status of patients with cancer. Oncol Nurs Forum 28(3):465–470PubMed
25.
Miaskowski C, Cooper BA, Paul SM, Dodd M, Lee K, Aouizerat BE et al (2006) Subgroups of patients with cancer with different symptom experiences and quality-of-life outcomes: a cluster analysis. Oncol Nurs Forum 33(5):E79–E89PubMedCrossRef
26.
Gift AG, Jablonski A, Stommel M, Given CW (2004) Symptom clusters in elderly patients with lung cancer. Oncol Nurs Forum 31(2):202–212PubMedCrossRef
27.
Walsh D, Rybicki L (2006) Symptom clustering in advanced cancer. Support Care Cancer 14(8):831–836PubMedCrossRef
28.
29.
Bender CM, Ergun FS, Rosenzweig MQ, Cohen SM, Sereika SM (2005) Symptom clusters in breast cancer across 3 phases of the disease. Cancer Nurs 28(3):219–225PubMedCrossRef
30.
Kim HJ, McGuire DB, Tulman L, Barsevick AM (2005) Symptom clusters: concept analysis and clinical implications for cancer nursing. Cancer Nurs 28(4):270–284PubMedCrossRef
31.
Barsevick AM, Dudley WN, Beck SL (2006) Cancer-related fatigue, depressive symptoms, and functional status: a mediation model. Nurs Res 55(5):366–372PubMedCrossRef
32.
Fox SW, Lyon DE (2006) Symptom clusters and quality of life in survivors of lung cancer. Oncol Nurs Forum 33(5):931–936PubMedCrossRef
33.
Parker KP, Kimble LP, Dunbar SB, Clark PC (2005) Symptom interactions as mechanisms underlying symptom pairs and clusters. J Nurs Scholarsh 37(3):209–215PubMedCrossRef
34.
Bevans MF, Marden S, Leidy NK, Soeken K, Cusack G, Rivera P et al (2006) Health-related quality of life in patients receiving reduced-intensity conditioning allogeneic hematopoietic stem cell transplantation. Bone Marrow Transplantation 38:101–109PubMedCrossRef
35.
McCorkle R, Cooley ME, Shea JA (1994) The user’s manual for the symptom distress scale. Instrument manual
36.
Lawrence CC, Gilbert CJ, Peters WP (1996) Evaluation of symptom distress in a bone marrow transplant outpatient environment. Ann Pharmacother 30(9):941–945PubMed
37.
Cooley ME, McCorkle L, Knafl GJ, Rimar J, Barbieri MJ, Davies M et al (2005) Comparison of health-related quality of life questionnaires in ambulatory oncology. Qual Life Res 14(5):1239–1249PubMedCrossRef
38.
Winer EP, Lindley C, Hardee M, Sawyer WT, Brunatti C, Borstelmann NA et al (1999) Quality of life in patients surviving at least 12 months following high dose chemotherapy with autologous bone marrow support. Psychooncology 8(2):167–176PubMedCrossRef
39.
Krupski TL, Sonn G, Kwan L, Maliski S, Fink A, Litwin M (2005) Ethnic variation in health-related quality of life among low-income men with prostate cancer. Ethn Dis 15:461–468PubMed
40.
Ware J, Snow K, Kosinski M, Gandel B (1997) SF-36 health survey. Manual and interpretation guide. The Health Institute, New England Medical Center, Boston
41.
Ware JJE, Kosinski M (2001) SF-36 Physical and Mental Health summary scales: a manual for users of version 1, 2nd edn. Quality Metric, Lincoln
42.
Dapueto JJ, Servente L, Francolino C, Hahn E (2005) Determinants of quality of life in patients with cancer. A South American study. Cancer 103:1072–1081PubMedCrossRef
43.
Vilagut G, Ferrer M, Rajmil L, Rebollo P, Permanyer-Miralda G, Quintana JM et al (2005) El Custionario de Salud SF-36 espanol: una decada de experiencia y nuevos desarrollos [The Spanish version of the Short Form 36 Health Survey: a decade of experience and new developments.]. Gaceta sanitaria 19(2):135–150PubMedCrossRef
44.
Kopp M, Schweigkofler H, Holzner B, Nachbaur D, Niederwieser D, Fleischhacker WW et al (1998) Time after bone marrow transplantation as an important variable for quality of life: results of a cross-sectional investigation using two different instruments for quality-of-life assessment. Ann Hematol 77(1–2):27–32PubMedCrossRef
45.
Hjermstad M, Holte H, Evensen S, Fayers P, Kaasa S (1999) Do patients who are treated with stem cell transplantation have a health-related quality of life comparable to the general population after 1 year. Bone Marrow Transplant 24(8):911–918PubMedCrossRef
46.
Syrjala KL, Chapko MK, Vitaliano PP, Cummings C, Sullivan KM (1993) Recovery after allogeneic marrow transplantation: prospective study of predictors of long-term physical and psychosocial functioning. Bone Marrow Transplant 11(4):319–327PubMed
47.
Larsen J, Nordstrom G, Ljungman P, Gardulf A (2007) Factors associated with poor general health after stem-cell transplantation. Support Care Cancer 15:849–857PubMedCrossRef
48.
Trask PC, Paterson A, Riba M, Brines B, Griffith K, Parker P et al (2002) Assessment of psychological distress in prospective bone marrow transplant patients. Bone Marrow Transplant 29(11):917–925PubMedCrossRef
49.
Andorsky DJ, Loberiza J, Lee SJ (2006) Pre-transplantation physical and mental functioning is strongly associated with self-reported recovery from stem cell transplantation. Bone Marrow Transplant 37(9):889–895PubMedCrossRef
50.
Hoodin F, Uberti JP, Lynch TJ, Steele P, Ratanatharathorn V (2006) Do negative or positive emotions differentially impact mortality after adult stem cell transplant. Bone Marrow Transplant 38(4):255–264PubMedCrossRef
51.
Prieto JM, Blanch J, Atala J, Carreras E, Rovira M, Cirera E et al (2002) Psychiatric morbidity and impact on hospital length of stay among hematologic cancer patients receiving stem-cell transplantation. J Clin Oncol 20(7):1907–1917PubMedCrossRef
52.
Molassiotis A (1999) Further evaluation of a scale to screen for risk of emotional difficulties in bone marrow transplant recipients. J Adv Nurs 29(4):922–927PubMedCrossRef
53.
Jacobs SR, Jacobsen PB, Booth-Jones M, Wagner LI, Anasetti C (2007) Evaluation of the functional assessment of cancer therapy cognitive scale with hematopoietic stem cell transplant patients. J Pain Symptom Manage 33(1):13–23PubMedCrossRef
54.
Bultz BD (2006) Emotional distress: the sixth vital sign—future directions in cancer care. Psycho-oncol 15(2):93–95CrossRef
55.
Ransom S, Jacobsen PB, Booth-Jones M (2006) Validation of the distress thermometer with bone marrow transplant patients. Psycho-oncol 15(7):604–612CrossRef
56.
Hacker (2003) Quantitative measurement of quality of life in adult patients undergoing bone marrow transplant or peripheral blood stem cell transplant: a decade of review. Oncol Nurs Forum 30(4):613–629PubMedCrossRef
57.
Berger AM, Parker KP, Young-McCaughan S, Mallory GA, Barsevick AM, Beck SL et al (2005) Sleep wake disturbances in people with cancer and their caregivers: state of the science. Oncol Nurs Forum 32(6):E98–E126PubMedCrossRef
58.
Byar KL, Berger AM, Bakken SL, Cetak MA (2006) Impact of adjuvant breast cancer chemotherapy on fatigue, other symptoms, and quality of life. Oncol Nurs Forum 33(1):E18–E26PubMedCrossRef
59.
Hinds PPSH (2007) Nocturnal awakenings, sleep environment interruptions, and fatigue in hospitalized children with cancer. Oncol Nurs Forum 34(2):393–402PubMedCrossRef
60.
Fann JR, Alfano CM, Roth-Roemer S, Katon WJ, Syrjala KL (2007) Impact of delirium on cognition, distress, and health-related quality of life after hematopoietic stem-cell transplantation. J Clin Oncol 25(10):1223–1231PubMedCrossRef
61.
Roscoe JA, Kaufman ME, Matteson-Rusby SE, Palesh OG, Ryan JL, Kohli S et al (2007) Cancer-related fatigue and sleep disorders. Oncologist 12(Suppl 1):35–42PubMedCrossRef
62.
Prieto JM, Blanch J, Atala J, Carreras E, Rovira M, Cirera E et al (2006) Clinical factors associated with fatigue in haematologic cancer patients receiving stem-cell transplantation. Eur J Cancer 42(12):1749–1755PubMedCrossRef
63.
Ryan JL, Carroll JK, Ryan EP, Mustian KM, Fiscella K, Morrow GR (2007) Mechanisms of cancer-related fatigue. Oncologist 12(Suppl 1):22–34PubMedCrossRef
64.
Mitchell SA, Beck SL, Hood LE, Moore K, Tanner ER (2007) Putting evidence into practice: evidence-based interventions for fatigue during and following cancer and its treatment. Clin J Oncol Nurs 11(1):99–113PubMedCrossRef
65.
Bellm LA, Epstein JB, Rose-Ped A, Martin P, Fuchs HJ (2000) Patient reports of complications of bone marrow transplantation. Support Care Cancer 8(1):33–39PubMed
66.
Cetkovsky P, Skopek P, Schutzova M (2000) Causative factors for prolonged hospitalization beyond the point of engraftment in patients after autologous peripheral blood stem cell transplantation. Bone Marrow Transplant 26(8):877–880PubMedCrossRef
67.
Sheean PM, Braunschweig C, Rich E (2004) The incidence of hyperglycemia in hematopoietic stem cell transplant recipients receiving total parenteral nutrition: a pilot study. J Am Diet Assoc 104(9):1352–1360PubMedCrossRef
68.
Grant M, Cooke L, Bhatia S, Forman SJ (2005) Discharge and unscheduled readmissions of adult patients undergoing hematopoietic stem cell transplantation: implications for developing nursing interventions. Oncol Nurs Forum 32(1):E1–E8PubMedCrossRef
69.
Malone FR, Leisenring WM, Storer BE, Lawler R, Stern JM, Aker SN et al (2007) Prolonged anorexia and elevated plasma cytokine levels following myeloablative allogeneic hematopoietic cell transplant. Bone Marrow Transplant 40:765–772PubMedCrossRef
70.
Mattsson J, Westin S, Edlund S, Remberger M (2006) Poor oral nutrition after allogeneic stem cell transplantation correlates significantly with severe graft-versus-host disease. Bone Marrow Transplant 38(9):629–633PubMedCrossRef
71.
Warnick E (2007) Gastrointestinal effects. In: Ezzone S, Schmit-Pokorny K (eds) Blood and marrow stem cell transplantation. Principles, practice, and nursing insights. Jones and Bartlett, Sudbury, Massachusetts, pp 207–243
72.
Anderson KO, Giralt SA, Mendoza TR, Brown JO, Neumann JL, Mobley GM et al (2007) Symptom burden in patients undergoing autologous stem-cell transplantation. Bone Marrow Transplant 39:759–766PubMedCrossRef
73.
Hoekstra J, Vernooij-Dassen MJFJ, de Vos R, Bindels PJE (2007) The added value of assessing the ‘most troublesome’ symptom among patients with cancer in the palliative phase. Patient Educ Couns 65(2):223–229PubMedCrossRef
74.
Schulz-Kindermann F, Mehnert A, Scherwath A, Schirmer L, Schleimer B, Zander AR et al (2007) Cognitive function in the acute course of allogeneic hematopoietic stem cell transplantation for hematological malignancies. Bone Marrow Transplant 39(12):789–799PubMedCrossRef
75.
Kurtz ME, Kurtz JC, Stommel M, Given CW, Given B (1999) The influence of symptoms, age, comorbidity and cancer site on physical functioning and mental health of geriatric women patients. Women Health 29(3):1–12PubMedCrossRef
76.
Gielissen MFM, Schattenberg AVM, Verhagen CAHH, Rinkes MJ, Bremmers MEJ, Bleijenberg G (2007) Experience of severe fatigue in long-term survivors of stem cell transplantation. Bone Marrow Transplant 39(10):595–603PubMedCrossRef
77.
Liavaag AH, Drum A, Fossa SD, Trope C, Dahl AA (2007) Controlled study of fatigue, quality of life, and somatic and mental morbidity in epithelial ovarian cancer survivors: How lucky are the lucky ones. J Clin Oncol 25(15):2049–2056PubMedCrossRef
78.
Young KE, White CA (2006) The prevalence and moderators of fatigue in people who have been successfully treated for cancer. J Psychosom Res 60(1):29–38PubMedCrossRef
79.
Wu D, Hockenbery DM, Brentnall TA, Baehr PH, Ponec RJ, Kuver R et al (1998) Persistent nausea and anorexia after marrow transplantation: a prospective study of 78 patients. Transplantation 66(10):1319–1324PubMedCrossRef
80.
Fowler DH, Foley J, Hou JWS, Odom J, Castro K, Steinberg SM et al (2004) Clinical “cytokine storm” as revealed by monocyte intracellular flow cytometry: correlation of tumor necrosis factor with severe gut graft-versus-host disease. Clin Gastroenterol Hepatol 2(3):237–245PubMedCrossRef
81.
Goker H, Haznedaroglu IC, Chao NJ (2001) Acute graft-vs-host disease: pathobiology and management. Exp Hematol 29(3):259–277PubMedCrossRef
82.
Rich T, Innominato PF, Boerner J, Mormont MC, Iacobelli S, Baron B et al (2005) Elevated serum cytokines correlated with altered behavior, serum cortisol rhythm, and dampened 24-hour rest-activity patterns in patients with metastatic colorectal cancer. Clin Cancer Res 11(5):1757–1764PubMedCrossRef
83.
Wood LJ, Nail LM, Perrin NA, Elsea CR, Fischer A, Druker BJ (2006) The cancer chemotherapy drug etoposide (VP-16) induces proinflammatory cytokine production and sickness behavior-like symptoms in a mouse model of cancer chemotherapy-related symptoms. Biol Res Nurs 8(2):157–169PubMedCrossRef
84.
Jacobsohn DA, Vogelsang GB (2007) Acute graft versus host disease. Orphanet Journal of Rare Diseases 2(1):35PubMedCrossRef
85.
Molassiotis A, Van Den Akker OB, Milligan DW, Goldman JM (1997) Symptom distress, coping style and biological variables as predictors of survival after bone marrow transplantation. J Psychosom Res 42(3):275–285PubMedCrossRef
Metadata
Title
The symptom experience in the first 100 days following allogeneic hematopoietic stem cell transplantation (HSCT)
Authors
Margaret F. Bevans
Sandra A. Mitchell
Susan Marden
Publication date
01-11-2008
Publisher
Springer-Verlag
Published in
Supportive Care in Cancer / Issue 11/2008
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-008-0420-6

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