Temporal trajectory of quality of life and its predictors in recipients of hematopoietic stem cell transplantation
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This prospective longitudinal study evaluated the temporal trajectory of health-related quality of life (HRQOL) and its associated factors in patients who received hematopoietic stem cell transplantation (SCT) 6 months after transplantation. Eighty-nine adult patients who were admitted to Seoul National University Hospital for SCT were consecutively included in the study. The participants completed three standardized questionnaires: Insomnia Severity Index, Hospital Anxiety and Depression Scale, and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire. The participants completed the study questionnaires at three time points: before SCT (T1), immediately after SCT (T1), and 6 months after SCT (T3). Immediately after SCT, HRQOL decreased significantly (p < 0.001), followed by recovery over 6 months. The conditioning regimen for SCT showed no correlation with HRQOL at T2 (p = 0.283) or T3 (p = 0.799), with no significant difference in HRQOL between allogeneic and autologous SCT recipients at T2 (p = 0.829) or T3 (p = 0.824). Depression (p = 0.042), pain (p = 0.023), and appetite loss (p = 0.004) negatively influenced HRQOL at T1, whereas only pain (p = 0.048) remained an important factor at T2. Six months after SCT, the two most frequent symptoms, fatigue and financial problems, became major factors (p = 0.004 and p = 0.005, respectively). Depression began to play an important role in HRQOL again at T3 (p = 0.040). These findings demonstrate that SCT recipients need both psychological and medical support to achieve a better HRQOL after SCT.
KeywordsStem cell transplantation Quality of life Supportive care Distress
We thank our database manager, Mijin Yoon, for her accurate data management and BioMed Proofreading LLC for English editing. This work was supported by grants from the Seoul National University Hospital Research Fund (no. 0420160240) and Seoul National University College of Medicine (no. 800-20140171 to I.K.).
R.K. contributed substantially to the manuscript by conceiving and constructing the analytical project, interpreting the data, and writing the first draft of the manuscript. R.K., Y.C., Y.K., B.J.H., and I.K. designed the study. J.H., D.Y.S., Y.K., B.J.H., and I.K. recruited the patients and analyzed the data. R.K., K.L.S., K.M.L., B.J.H., and I.K. contributed to the data analysis and interpretation and read, edited, and approved the final manuscript. All of the authors reviewed and approved the initial and final versions of the manuscript.
Compliance with ethical standards
This protocol was approved by the Institutional Review Board at SNUH (IRB approval no. H-1005-043-318) and was conducted in accordance with Declaration of Helsinki provisions.
Conflicts of interest
The authors have no conflicts of interest to declare or other disclosures.
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