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Vision-specific and cancer-specific quality of life in ocular graft-versus-host disease after allogeneic hematopoietic stem cell transplantation

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Abstract

Purpose

To compare the vision-specific and cancer-specific quality of life (QOL) between patients with and without ocular graft-versus-host disease (oGVHD) after allogeneic hematopoietic stem cell transplantation (alloHCT).

Methods

This cross-sectional observational study analyzed 142 patients after alloHCT including 94 patients with oGVHD and 48 without. oGVHD was diagnosed according to International Chronic Ocular GVHD Consensus Group (ICOGCG) criteria. QOL was assessed by using the 25-item National Eye Institute Visual Function Questionnaire (NEI VFQ-25) and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30).

Results

Compared with non-oGVHD patients, patients with oGVHD had worse vision-specific (NEI VFQ-25: 64.3 ± 20.3 vs. 77.6 ± 19.3, P < 0.001) and cancer-specific (EORTC QLQ-C30: 59.9 ± 20.3 vs. 67.4 ± 17.5, P = 0.03) QOL, as well as impaired cognitive function (72.7 ± 22.1 vs. 82.3 ± 19.0, P = 0.01). The vision-specific QOL was significantly correlated with ICOGCG score (β =  − 1.88, 95%CI: − 3.35 to − 0.41, P = 0.01) and post-alloHCT medical expense (β =  − 5.70, 95%CI: − 10.35 to − 1.05, P = 0.02), while cancer-specific QOL was strikingly correlated with post-alloHCT medical expense (β =  − 9.91, 95%CI: − 14.43 to − 5.39, P < 0.001), frequency of ophthalmic medication (β =  − 0.93, 95%CI: − 1.64 to − 0.21, P = 0.01), education (β =  − 6.97, 95%CI: − 13.31 to − 0.62, P = 0.03), and peripheral blood stem cell use (β =  − 6.42, 95%CI: − 12.59 to − 0.25, P = 0.04).

Conclusions

Patients with oGVHD experienced significant impairment in both vision-specific and cancer-specific QOL including cognitive function when compared with those without after alloHCT. Multidimensional QOL assessment should be included in the long-term alloHCT survivorship care.

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Funding

This study is supported by a grant (82070922) from the National Natural Science Foundation of China, a grant (2019A1515012012) from the Natural Science Foundation of Guangdong Province, and a grant (303020101) from the High-Level Hospital Construction Project of Guangdong Province. The sponsors or funding organizations had no role in the design or conduct of this research.

Author information

Authors and Affiliations

  1. State Key Laboratory of Ophthalmology, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Disease, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, 510060, China

    Yinglin Liao, Wenxin Zhao, Jing Yang, Shaowen Wu, Ling Jin & Lingyi Liang

  2. Department of Hematology, Nanfang Hospital, Southern Medical University, 1838S North of Guangzhou Avenue, Guangzhou, 510515, China

    Fen Huang

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  1. Yinglin Liao
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  5. Ling Jin
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  6. Fen Huang
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Yinglin Liao, Wenxin Zhao, Jing Yang, Shaowen Wu, and Ling Jin. The first draft of the manuscript was written by Yinglin Liao, Lingyi Liang, and Fen Huang, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Fen Huang or Lingyi Liang.

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Ethics approval and consent to participate

The study was approved by the ethic committee of Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China (No. 2019KYPJ135), and was conducted according to the Declaration of Helsinki. Written informed consent was obtained from all participants.

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Liao, Y., Zhao, W., Yang, J. et al. Vision-specific and cancer-specific quality of life in ocular graft-versus-host disease after allogeneic hematopoietic stem cell transplantation. Graefes Arch Clin Exp Ophthalmol 261, 453–465 (2023). https://doi.org/10.1007/s00417-022-05812-5

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