Skip to main content

Advertisement

SpringerLink
Log in

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

  • Original Article
  • Published:
Supportive Care in Cancer Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. 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):62–71. https://doi.org/10.1016/j.pec.2003.12.007

    Article  PubMed  Google Scholar 

  2. Mosher CE, Duhamel KN, Rini C, Corner G, Lam J, Redd WH (2011) Quality of life concerns and depression among hematopoietic stem cell transplant survivors. Support Care Cancer 19(9):1357–1365. https://doi.org/10.1007/s00520-010-0958-y

    Article  PubMed  Google Scholar 

  3. Andersson I, Ahlberg K, Stockelberg D, Persson LO (2011) Patients’ perception of health-related quality of life during the first year after autologous and allogeneic stem cell transplantation. Eur J Cancer Care 20(3):368–379. https://doi.org/10.1111/j.1365-2354.2009.01174.x

    Article  CAS  Google Scholar 

  4. Grulke N, Albani C, Bailer H (2012) Quality of life in patients before and after haematopoietic stem cell transplantation measured with the European Organization for Research and Treatatment of Cancer (EORTC) quality of life core questionnaire (QLQ-C30). Bone Marrow Transplant 47(4):473–482. https://doi.org/10.1038/bmt.2011.107

    Article  PubMed  CAS  Google Scholar 

  5. Frödin U, Börjeson S, Lyth J, Lofti K (2011) A prospective evaluation of patients’ health-related quality of life during auto-SCT: a 3-year follow-up. Bone Marrow Transplant 46(10):1345–1352. https://doi.org/10.1038/bmt.2010.304

    Article  PubMed  Google Scholar 

  6. 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 Transplant 37:101–109

    Article  Google Scholar 

  7. Devins GM, Bezjak A, Mah K, Loblaw DA, Gotowiec A (2006) Context moderates illness-induced lifestyle disruptions across life domains: a test of the illness intrusiveness theoretical framework in six common cancers. Psycho-Oncology 15(3):221–233. https://doi.org/10.1002/pon.940

    Article  PubMed  Google Scholar 

  8. Schimmer AD, Elliott ME, Abbey SE, Raiz L, Keating A, Beanlands HJ, McCay E, Messner HA, Lipton JH, Devins GM (2001) Illness intrusiveness in survivors of autologous bone and marrow transplantation. Cancer 92(12):3147–3154. https://doi.org/10.1002/1097-0142(20011215)92:12<3147::AID-CNCR10168>3.0.CO;2-C

    Article  PubMed  CAS  Google Scholar 

  9. Bradburn NM (1969) The structure of psychological well-being, 1st edn. Aldine, Chicago

    Google Scholar 

  10. Allart P, Soubeyran P, Cousson-Gélie F (2013) Are psychosocial factors associated with quality of life in patients with haematological cancer? A critical review of the literature. Psycho-Oncology 22(2):241–249

    PubMed  Google Scholar 

  11. Morishita S, Kaida K, Ikegame K, Yoshihara S, Taniguchi K, Okada M, Kodama N, Ogawa H, Domen K (2012) Impaired physiological function and health-related QOL in patients before hematopoietic stem-cell transplantation. Support Care Cancer 20(4):821–829. https://doi.org/10.1007/s00520-011-1156-2

    Article  PubMed  Google Scholar 

  12. Andrykowski MA, Brady MJ, Greiner CB, Altmaier EM, Burish TG, Antin JH et al (1995) Returning to normal following bone marrow transplantation: outcomes, expectations and informed consent. Bone Marrow Transplant 15(4):573–581

    PubMed  CAS  Google Scholar 

  13. Devins GM, Binik YM, Hutchinson TA, Hollomby DJ, Barre PE, Guttmann RD (1983) The emotional impact of end-stage renal disease: importance of patients’ perceptions of intrusiveness and control. Int J Psychiatry Med 13(4):327–343

    Article  PubMed  Google Scholar 

  14. Devins GM (2010) Using the illness intrusiveness ratings scale to understand health-related quality of life in chronic disease. J Psychosom Res 68(6):591–602. https://doi.org/10.1016/j.jpsychores.2009.05.006

    Article  PubMed  Google Scholar 

  15. Devins GM, Dion R, Pelletier LG, Shapiro CM, Abbey SE, Raiz L et al (2001) The structure of lifestyle disruptions in chronic disease: a confirmatory factor analysis of the illness intrusiveness ratings scale. Med Care 39(10):1097–1104. https://doi.org/10.1097/00005650-200110000-00007

    Article  PubMed  CAS  Google Scholar 

  16. Nunnally JC (1978) Psychometric theory, 2nd edn. McGraw-Hill, New York

    Google Scholar 

  17. Radloff LS (1977) The CES-D scale: a self-report depression scale for research in the general population. Appl Psychol Meas 1(3):385–401. https://doi.org/10.1177/014662167700100306

    Article  Google Scholar 

  18. Katz MR, Kopek N, Waldron J, Devins GM, Tomlinson G (2004) Screening for depression in head and neck cancer. Psycho-Oncology 13(4):269–280. https://doi.org/10.1002/pon.734

    Article  PubMed  Google Scholar 

  19. Devins GM, Orme CM, Costello CG, Binik YM, Frizzell B, Stam HJ et al (1988) Measuring depressive symptoms in illness populations: psychometric properties of the Center for Epidemiologic Studies Depression (CES-D) scale. Psychol Health 2:139–156

    Article  Google Scholar 

  20. Rosenberg M (1965) Society and the adolescent self-image. Princeton University Press, Princeton

    Book  Google Scholar 

  21. Robinson JP, Shaver PR, Wrightsman LS (1991) Measures of personality and social psychological attitudes. Academic Press, San Diego

    Google Scholar 

  22. Portenoy RK, Thaler HT, Kornblith AB, Lepore JM, Friedlander-Klar H, Kiyasu E et al (1994) The memorial symptom assessment scale: an instrument for the evaluation of symptom prevalence, characteristics and distress. Eur J Cancer 30A(9):1326–1336

    Article  PubMed  CAS  Google Scholar 

  23. Beanlands HJ, Lipton JH, McCay EA, Schimmer AD, Elliott ME, Messner HA, Devins GM (2003) Self-concept as a “BMT patient”, illness intrusiveness, and engulfment in allogeneic bone marrow transplant recipients. J Psychosom Res 55(5):419–425. https://doi.org/10.1016/S0022-3999(03)00509-9

    Article  PubMed  Google Scholar 

  24. Raudenbush SW (2001) Comparing personal trajectories and drawing causal inferences from longitudinal data. Annu Rev Psychol 52(1):501–525. https://doi.org/10.1146/annurev.psych.52.1.501

    Article  PubMed  CAS  Google Scholar 

  25. Singer JD, Willett JB (2003) Applied longitudinal data analysis: modeling change and event occurrence. Oxford University Press, New York

    Book  Google Scholar 

  26. Beattie S, Lebel S (2011) The experience of caregivers of hematological cancer patients undergoing a hematopoietic stem cell transplant: a comprehensive literature review. Psycho-Oncology 20(11):1137–1150. https://doi.org/10.1002/pon.1962

    Article  PubMed  Google Scholar 

  27. Waraich P, Goldner EM, Somers JM, Hsu L (2004) Prevalence and incidence studies of mood disorders: a systematic review of the literature. Can J Psychiatr 49(2):124–138. https://doi.org/10.1177/070674370404900208

    Article  Google Scholar 

  28. Fall-Dickson JM, Mitchell SA, Marden S, Ramsay ES, Guadagnini J-P, Wu T, St John L, Pavletic SZ, National Institutes of Health Chronic Graft-versus-Host Disease Study Group (2010) Oral symptom intensity, health-related quality of life, and correlative salivary cytokines in adult survivors of hematopoietic stem cell transplantation with oral chronic graft-versus-host disease. Biol Blood Marrow Transplant 16(7):948–956. https://doi.org/10.1016/j.bbmt.2010.01.017

    Article  PubMed  PubMed Central  Google Scholar 

  29. Coyne JC, Benazon NR, Gaba CG, Calzone K, Weber BL (2000) Distress and psychiatric morbidity among women from high-risk breast and ovarian cancer families. J Consult Clin Psychol 68(5):864–874. https://doi.org/10.1037/0022-006X.68.5.864

    Article  PubMed  CAS  Google Scholar 

  30. Devins GM, Payne AYM, Lebel S, Mah K, Lee RNF, Irish JC et al (2013) The burden of stress in head and neck cancer. Psycho-Oncology 22(3):668–676. https://doi.org/10.1002/pon.3050

    Article  PubMed  Google Scholar 

  31. Devins GM, Otto KJ, Irish JC, Rodin GM (2015) Head and neck cancer. In: Holland JC, Breitbart WS, Butow PN, Jacobsen PB, Loscalzo MJ, McCorkle R (eds) , 3rd edn. Oxford University Press, New York, pp 92–97

    Google Scholar 

Download references

Funding

This study is funded by the Canadian Institutes of Health Research grant (200203MOP-99309) to G.M. Devins.

Author information

Authors and Affiliations

  1. Princess Margaret Cancer Centre, Toronto, ON, Canada

    Gerald M. Devins, Kenneth Mah, Hans A. Messner & Jeffrey H. Lipton

  2. University of Toronto, Toronto, ON, Canada

    Gerald M. Devins, Hans A. Messner & Jeffrey H. Lipton

  3. London Health Sciences Centre, London, ON, Canada

    Anargyros Xenocostas

  4. University of Western Ontario, London, ON, Canada

    Anargyros Xenocostas

  5. Université de Montréal, Montreal, QC, Canada

    Lise Gauvin

Authors
  1. Gerald M. Devins
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kenneth Mah
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Hans A. Messner
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Anargyros Xenocostas
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Lise Gauvin
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Jeffrey H. Lipton
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jeffrey H. Lipton.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Disclaimer

Primary data is under full control of the lead author and available to the journal for full review.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Devins, G.M., Mah, K., Messner, H.A. et al. Quality of life trajectories during the first year following hematopoietic cell transplantation: an inception cohort study. Support Care Cancer 26, 2379–2386 (2018). https://doi.org/10.1007/s00520-018-4059-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00520-018-4059-7

Keywords

Search

Navigation