Supportive Care in Cancer

, Volume 16, Issue 11, pp 1243–1254 | Cite as

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

  • Margaret F. BevansEmail author
  • Sandra A. Mitchell
  • Susan Marden
Original Article


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.


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


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).


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.


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.


Complications Cancer Recovery Clinical assessment Symptom burden 



We would like to thank Olena Prachenko, Nancy Kline Leidy, Karen Soeken, John Barrett, Richard Childs, Michael Bishop, Georgie Cusack, Helen Mayberry, Priscilla Rivera, Clare Hastings, Gwenyth Wallen, and the clinical and research BMT teams at the Clinical Center, NIH.


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Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • Margaret F. Bevans
    • 1
    • 3
    Email author
  • Sandra A. Mitchell
    • 1
  • Susan Marden
    • 2
  1. 1.National Institutes of Health, Clinical CenterBethesdaUSA
  2. 2.National Institutes of Health, Clinical CenterBethesdaUSA
  3. 3.ColumbiaUSA

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