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Factors associated with poor general health after stem-cell transplantation

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Abstract

Aims

To describe functional status (FS), general health (GH) and symptom distress (SD) from admission to 1 year post-SCT and to identify medical, demographic, and/or patient-reported outcome variables associated with patient-perceived GH.

Material and methods

Forty-one patients (27 women) with a median age of 44 (18–65) years answered three questionnaires (SIP, SWED-QUAL, and SFID-SCT) from admission to 1 year post-SCT.

Results

At discharge, 59% of the patients reported poor FS and GH, and 24% reported >10 simultaneous symptoms. After 1 year post-SCT, 22% still reported poor FS, 32% poor GH, and 12% >10 simultaneous symptoms. Compared with admission, significantly larger proportions of the patients reported poor GH at discharge (20 vs 59%, p = .001), poor FS at 6 months (24 vs 59%, p = .004), and poor GH [The number of symptoms was found to be significantly associated with poor GH at discharge (OR 1.330, p = .009) and at 1 year post-SCT (OR 2.000, p = .010)]. Patients reporting “poor GH” at discharge and at 1 year post-SCT reported a median of 7 and 10 symptoms, respectively. Patients with “good GH” reported a median of three symptoms both at T1 and T4. “Tiredness”, “anxiety”, “mouth dryness”, “loss of appetite”, and “diarrhoea” were reported by a larger proportion of the patients reporting “poor GH”.

Conclusions

The results confirm that some patients who have undergone a SCT have a negatively affected life situation. The study indicates that actively asking for symptoms and applying the best treatment for symptom alleviation are among the most important measures that SCT teams can take to help the patients perceive better general health and an improved life situation.

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Acknowledgements

We wish to express our gratitude to the staff at the Department of Hematology and the Center for Allogeneic Stem-Cell Transplantation at the Karolinska University Hospital at Huddinge, Stockholm, for help with including patients in the study. We are also grateful to Hilary Hocking for language revision and Katarina Wiberg Hedman for support with the statistical analyses. This study was supported by grants from the Gunnar, Arvid, and Elisabeth Nilsson Fund for Combating Cancer, the Swedish Foundation for Health Care Sciences and Allergy Research, the Tobias Foundation, the Research Committee for Caring Sciences at Karolinska Institutet, the Nursing Development and Research Committee at Huddinge University Hospital, and the Committee for Research and Education at Karolinska University Hospital (Stockholm, Sweden).

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Authors and Affiliations

  1. Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, 23300, 141 83 Huddinge, Stockholm, Sweden

    Joacim Larsen & Gun Nordström

  2. Division for Oncology and Haematology, Karolinska University Hospital, Stockholm, Sweden

    Joacim Larsen

  3. Haematology Centre, Karolinska University Hospital, Stockholm, Sweden

    Joacim Larsen & Per Ljungman

  4. Division of Health and Caring Sciences, Karlstad University, Karlstad, Sweden

    Gun Nordström

  5. Division of Haematology, Department of Medicine, Karolinska Institutet at Karolinska University Hospital, Huddinge, Stockholm, Sweden

    Per Ljungman

  6. Immunology, Department of Laboratory Medicine, Karolinska Institutet at Karolinska University Hospital, Huddinge, Stockholm, Sweden

    Ann Gardulf

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  1. Joacim Larsen
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Correspondence to Joacim Larsen.

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Larsen, J., Nordström, G., Ljungman, P. et al. Factors associated with poor general health after stem-cell transplantation. Support Care Cancer 15, 849–857 (2007). https://doi.org/10.1007/s00520-006-0200-0

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