Recovery after stem-cell transplantation for hematologic diseases

Purpose: Although the number of autologous and allogeneic stem-cell transpl antations (SCT) is increasing, relatively little information about recovery after transplantation is available. Quantitative information appropriate f or patient counseling is difficult to discern From the literature. We sough t to suggest reasonable expectations for recovery and symptoms after SCT fo r hematologic malignancies and other disorders using the following measures : (1) objective measures of health status, such as frequency of clinic visi ts, need for rehospitalization, medication usage, work status, and overall and event-free survival; (2) qualitative assessment of quality of life, suc h as returning to ct normal life, resumption of normal activities, satisfac tion with appearance, and whether recovery has occurred; and (3) quantifica tion of specific bothersome symptoms. Patients and Methods: Autologous and allogeneic SCT recipients at a tertiar y-care transplant center participated in the prospective, longitudinal ques tionnaire study. Results: Three hundred twenty patients were studied. Questionnaire response rates at 6, 12, and 24 months range from 85% to 88% among survivors. Altho ugh autologous patients had better event-free and overall survival, fewer s ymptoms, and more complete recovery at 6 months, these advantages had large ly equalized by 12 months. Specific bothersome symptoms were reported by le ss than 24% of patients after transplantation, except for fatigue and finan cial and sexual difficulties, which were more prevalent. Conclusion: There findings may help counsel patients considering transplant ation and educate them about reasonable expectations for recovery. Overall, the low level of bothersome symptoms and continued recovery through the fi rst year after transplantation are encouraging. J Clin Oncol 19:242-252. (C ) 2001 by American Society of Clinical Oncology.