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Supportive Care in Cancer

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01-07-2018 | Original Article

Quality of life trajectories during the first year following hematopoietic cell transplantation: an inception cohort study

Authors: Gerald M. Devins, Kenneth Mah, Hans A. Messner, Anargyros Xenocostas, Lise Gauvin, Jeffrey H. Lipton

Published in: Supportive Care in Cancer | Issue 7/2018

Abstract

Background

Allogeneic hematopoietic cell transplantation (HCT) affects quality of life (QOL). Patient-reported outcomes examine symptoms, side effects, distress, and physical and social problems, but positive outcomes have been ignored. This inception cohort study followed people over the first year following HCT to document positive and negative outcomes.

Methods

People with hematologic cancers treated by HCT completed complementary self-report instruments at four milestones: (a) pre-transplant (N = 88); (b) engraftment (N = 80); (c) short-term post-discharge (N = 60); and (d) long-term post-discharge (N = 45). We examined symptoms, side effects, illness intrusiveness, depressive symptoms, positive and negative affect, and self-esteem. We compared QOL in HCT with diverse published values.

Results

QOL deteriorated following HCT. Most variables returned to baseline by short-term post-discharge, but self-esteem and illness intrusiveness required more time. Illness intrusiveness at 1 year post-discharge was higher in HCT than other cancer groups; negative affect, too, was higher, but HCT survivors also reported higher positive affect. HCT and other cancer survivors reported similar depressive symptom levels. Compared to healthy people, HCT survivors reported more severe depressive symptoms, but similar positive and negative affect.

Conclusions

QOL changes dramatically following HCT. People report more interference with valued activities and interests after 1 year than survivors of other cancers, but depressive symptoms are not higher. Positive and negative affect are equivalent to healthy community residents. Continued involvement in psychologically meaningful activities may preserve QOL.

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Title: Quality of life trajectories during the first year following hematopoietic cell transplantation: an inception cohort study
Authors: Gerald M. Devins
Kenneth Mah
Hans A. Messner
Anargyros Xenocostas
Lise Gauvin
Jeffrey H. Lipton
Publication date: 01-07-2018
Publisher: Springer Berlin Heidelberg
Published in: Supportive Care in Cancer / Issue 7/2018
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-018-4059-7

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Abstract

Background

Methods

Results

Conclusions

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