Quality of life in patients surviving at least 12 months following high dose chemotherapy with autologous bone marrow support

Background: Over the past decade, high dose chemotherapy with autologous bo ne marrow (HDC-ABMT) support has been used increasingly in the treatment of patients with breast cancer. In evaluating the results of HDC-ABMT in pati ents with breast cancer, an assessment of quality of life can add to the tr aditional endpoints (toxicity, and disease-free and overall survival) that are routinely assessed in clinical trials. Purpose: This study evaluated the quality of life (QOL) of breast cancer pa tients who had survived 1 or more years following high dose chemotherapy wi th autologous bone marrow transplant (HDC-ABMT) support. Methods: Eighty-two patients who had undergone HDC-ABMT were surveyed by wr itten questionnaire and follow-up telephone interview at least 1 year follo wing HDC-ABMT. Patients were asked to complete the Functional Living Index- Cancer (FLIC), the Symptom Distress Scale (SDS), and a survey of sexual fun ction developed as part of the study. Results: The mean FLIC score among all patients was 130 +/- 19.1 (possible range 22-154). FLIC scores were significantly lower in patients with eviden ce of recurrent disease than in patients who were free of disease. The most commonly reported symptoms after HDC-ABMT were insomnia, fatigue, and pain . Sexual interest and sexual activity were reported to be lower after parti cipation in HDC-ABMT than prior to the procedure. The majority of patients who were employed outside the home prior to HDC-ABMT returned to work with a median time away from work of 48 weeks. Conclusions: Patients with breast cancer who survive 1 or more years follow ing HDC-ABMT rate their QOL at a relatively high level and frequently retur n to work. Less than one-third of patients who were interviewed reported mo derate to severe symptoms. Problems with sexual functioning were common. Implications: Future research is needed on long-term outcomes after HDC-ABM T and on specific areas of concern, such as sexual functioning. Copyright ( C) 1999 John Wiley & Sons, Ltd.