PHYSICAL AND PSYCHOSOCIAL FUNCTIONING OF 117 SURVIVORS OF BONE-MARROWTRANSPLANTATION

All surviving patients receiving a BMT at our center since 1976 were s urveyed. Among 163 eligible patients, 145 were contacted and 117 (81%) responded. Their median follow-up was 55 months (range 6-154). The re search instruments consisted of a demographic questionnaire, a current medical status form, a quality of life questionnaire (Nottingham Heal th Profile), and a screening instrument for psychiatric morbidity (the 28-item version of the General Health Questionnaire). Current functio ning varied considerably across patients. They reported a high use of medical services (37%) and varied ongoing medical problems within the last 6 months. Most of them (93%) received Karnofsky ratings of 80 or above. Eight percent had current chronic GVHD. Comparing our patients' quality of life with a British reference population, most important d ifferences were found for physical mobility, work, and sex life. Psych iatric morbidity in BMT survivors was higher than in a Spanish general population. Multivariate analyses revealed that a higher systemic sym ptomatology score, a lower educational level, an older age at BMT, a s horter time post-BMT, a female gender, and impotence were significant predictors of an impaired overall quality of life. Similarly, a higher systemic symptomatology score, a shorter time post-BMT, a higher numb er of major infections, and a lower educational level were predictive factors of a higher psychosocial distress. No differences in quality o f life or psychosocial status between allogeneic and autologous transp lants were found. Quality of life and psychosocial distress improved w ith the passage of time, specially within the first 3 years.