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Health-Related Quality of Life 1 Year After Allogeneic or Autologous Stem-Cell Transplantation: A Prospective Study

From the Norwegian Cancer Society, Department of Oncology, Norwegian Radium Hospital, and Medical Department A, National Hospital, Oslo, Norway; Palliative Medicine Unit, Department of Oncology, Trondheim University Hospital, and Norwegian University of Science and Technology, Faculty of Medicine, Unit for Applied Clinical Research, Trondheim, Norway; and Medical Research Council Cancer Trials Office, Cambridge, United Kingdom.

Address reprint requests to Marianne Jensen Hjermstad, RN, MPH, Department of Oncology, The Norwegian Radium Hospital, Montebello, N-0310 Oslo, Norway; email mlhjerm{at}online.no

PURPOSE: To evaluate health-related quality of life (HRQOL) in adults treated with high-dose chemotherapy followed by allogeneic (SCT) and autologous (ASCT) stem-cell transplantation 1 year after transplantation, using data from 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 Organization 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 differences of 10 or more points on the 0 to 100 scales were found for 10 of 15 scales and items (P .01) between the SCT and ASCT groups. 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 = .0001) 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 across groups were smaller after 1 year; cognitive function was the only scale with a statistically significant difference (ASCT 80 v CT 89; P = .002).

Patterns of change in HRQOL scores were different between groups during follow-up. A great improvement was found in the ASCT group (P < .01 for emotional and role function, fatigue, appetite, and constipation), whereas no significant changes were observed for the SCT group.

CONCLUSION: Prospective studies with extended follow-up periods are necessary to separate a slow recovery process from more permanently reduced HRQOL after transplantation and to examine the late side effects from previous treatment.

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