Mj. Hjermstad et al., Health-related quality of life 1 year after allogeneic or autologous stem-cell transplantation: A prospective study, J CL ONCOL, 17(2), 1999, pp. 706-718
Purpose: To evaluate health-related duality of life (HRQOL) in adults treat
ed with high-dose chemotherapy followed by allogeneic (SCT) and autologous
(ASCT) stem-cell transplantation 1 year after transplantation, using data f
rom concurrent lymphoma patients receiving combination chemotherapy (CT) as
a reference.
Materials and Methods: Forty-one leukemia patients (SCT group), 51 lymphoma
patients (ASCT group), and 85 CT patients completed the European Organisat
ion for Research and treatment of Cancer QLQ-C30 questionnaire at baseline
and after 1 year.
Results: The SCT group (median age, 36 years) had better functioning scores
and less symptomatology at baseline compared with the ASCT (median age, 41
years) and CT (median age, 37 years) groups. Statistically significant dif
ferences of 10 or more points on the 0 to 100 scales were found for 10 of 1
5 scales and items (P less than or equal to.01) between the SCT and ASCT gr
oups. Global quality of life (79 v 58, P <.0001), role function (83 v 65, P
=.001), sleep disturbances (6 v 28, P <.0001), and fatigue (25 v 44, P =.0
001) deviated most. The differences were 10 or more points for seven of 15
scales and items comparing the SCT and CT groups, with sleep disturbances (
6 v 35, P <.0001) and pain (11 v 29, P <.01) deviating most. Differences ac
ross groups were smaller after 1 year; cognitive function was the only scal
e with a statistically significant difference (ASCT 80 v CT 89; P =.002). P
atterns of change in HRQOL scores were different between groups during foll
ow-vp. A great improvement was found in the ASCT group (P <.01 for emotiona
l and role function, fatigue, appetite, and constipation), whereas no signi
ficant changes were observed for the SCT group,
Conclusion: Prospective studies with extended follow-up periods are necessa
ry to separate a slow recovery process from more permanently reduced HRQOL
after transplantation and to examine the late side effects from previous tr
eatment. (C) 1999 by American Society of Clinical Oncology.