Quality of life concerns and depression among hematopoietic stem cell transplant survivors

Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, 641 Lexington Avenue, 7th Floor, New York, NY 10022, USA.
Supportive Care in Cancer (Impact Factor: 2.36). 09/2011; 19(9):1357-65. DOI: 10.1007/s00520-010-0958-y
Source: PubMed


This study examined quality of life, transplant-related concerns, and depressive symptoms and their demographic and medical correlates at 1 to 3 years following hematopoietic stem cell transplantation (HSCT).
HSCT survivors (N=406) completed telephone-administered questionnaires that assessed demographic variables, functional status, quality of life, transplant-related concerns, and depressive symptoms.
The most prevalent concerns among HSCT survivors included physical symptoms (e.g., fatigue and pain), maintaining current health status and employment, changes in appearance, and lack of sexual interest and satisfaction. In addition, almost one-third (32%) of survivors age 40 years and younger reported concern about their ability to have children. Unemployed survivors and those with lower incomes and worse functional status were more likely to experience poorer quality of life in multiple domains. Fifteen percent of the sample reported moderate to severe depressive symptoms, and these symptoms were higher among allogeneic transplant recipients and those with lower functional status.
Results suggest that interventions are needed to address physical symptoms, coping with an uncertain future, infertility, and sexual issues during the early phase of HSCT survivorship.

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    • "In fact, it was also observed in other studies performed at various time intervals after transplantation that patients generally had low quality of life12-14, they had the lowest quality of life particularly in the second week of transplantation10 and complications and some health-related problems were experienced in the early stage (first 100 days), mid stage (100 days-1 year) and in the long-term (later than a year).11 Again in this period, patients were reported to have experienced changes in especially their physical symptoms, body images and sexual lives15-17, further worsening of their health conditions, job losses17, social problems13 and financial problems.18 In the post-transplantation period, patients commonly had fatigue11,14,15 and faced problems such as anxiety, depressive symptoms17, loss of energy, headache, dizziness19, concern for the future, and fear of relapse.13 "
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    ABSTRACT: Objective: This study was conducted thinking that it was extremely important in terms of the disease and treatment to assess the symptoms that may be encountered before and after a stem cell transplantation and quality of life. Methodology: A prospective longitudinal design was used.The study was completed in two years on 82 patients who underwent transplantation at the bone marrow transplantation unit. Data were collected using a questionnaire, the Edmonton Symptom Assessment Scale, and the Short Form-36 quality of life scale. Results: It was observed that the patients had low mean scores of physical and mental quality of life both before and after transplantation; there was an increase in the mean scores of all the symptoms and primarily of fatigue after the stem cell transplantation as compared to before it; and the mean scores of physical and mental quality of life further declined (p<0.05). Conclusion: Quality of life of patients who underwent stem cell transplantation is adversely affected in the periods immediately before and after transplantation. Patients’ quality of life worsens as the severity of symptoms experienced by patients increases.
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