This Article Full Text Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Save to my personal folders Download to citation manager Rights & Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Syrjala, K. L. Articles by Martin, P. J. Search for Related Content PubMed PubMed Citation Articles by Syrjala, K. L. Articles by Martin, P. J. Social Bookmarking                            What's this?

Late Effects of Hematopoietic Cell Transplantation Among 10-Year Adult Survivors Compared With Case-Matched Controls

From the Clinical Research Division, Fred Hutchinson Cancer Research Center; Department of Psychiatry and Department of Behavioral Sciences; Department of Medicine, School of Medicine; and School of Social Work, University of Washington, Seattle, WA

Address reprint requests to Karen Syrjala, PhD, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave. N., D5-220, Seattle, WA, 98109; e-mail: ksyrjala{at}fhcrc.org

PURPOSE: To determine late effects of hematopoietic cell transplantation (HCT) on health problems and health-related quality of life for 10-year survivors.

PATIENTS AND METHODS: Four hundred five adults consented to the study before HCT. Medical records and standardized self-report measures were maintained prospectively. After 10 years, 137 survivors and nontransplant controls, case-matched on age, sex, and race, completed self-report of medical problems, symptoms, and health-related quality of life.

RESULTS: Survivors and controls had similar rates of hospitalization and most diseases, but survivors reported an average of 3.5 medical problems versus 1.7 for controls (P < .001). Survivors reported more musculoskeletal stiffness, cramps, weakness and joint swelling (P < .001), cataract surgery (P < .001), hepatitis C (P = .004), sexual problems for men (P = .01) and women (P < .001), restrictions in social function (P = .002), memory and attention concerns (P = .003), urinary frequency or leaking (P = .006), use of psychotropic medication (P = .009), and denial of life and health insurance (P < .001). Survivors and controls did not differ in self-reported rates of osteoporosis, hypothyroidism, employment, marital satisfaction, divorce, or psychological health.

CONCLUSION: Although indistinguishable in many respects, survivors had more medical needs than controls. Health problems were not focused on specific diseases or limited to survivors with readily identifiable risk factors. Musculoskeletal problems require both screening and research into etiologies and effective treatments. Osteoporosis and hypothyroidism may be underdiagnosed. Survivors require screening for sexual problems, urinary frequency, mood and need for antidepressants or benzodiazepines.

Supported by Grants No. CA63030 and CA78990 from the National Cancer Institute.

Presented in part at the American Psychosocial Oncology Society 2nd annual meeting, Phoenix, AZ, January 27–29, 2005.

Authors' disclosures of potential conflicts of interest are found at the end of this article.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Facebook    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				J. Pidala, C. Anasetti, and H. Jim Quality of life after allogeneic hematopoietic cell transplantation Blood, July 2, 2009; 114(1): 7 - 19. [Abstract] [Full Text] [PDF]

				A. G. E. M. de Boer, T. Taskila, A. Ojajarvi, F. J. H. van Dijk, and J. H. A. M. Verbeek Cancer Survivors and Unemployment: A Meta-analysis and Meta-regression JAMA, February 18, 2009; 301(7): 753 - 762. [Abstract] [Full Text] [PDF]

				S. H. Armenian, C.-L. Sun, L. Francisco, J. Steinberger, S. Kurian, F. L. Wong, J. Sharp, R. Sposto, S. J. Forman, and S. Bhatia Late Congestive Heart Failure After Hematopoietic Cell Transplantation J. Clin. Oncol., December 1, 2008; 26(34): 5537 - 5543. [Abstract] [Full Text] [PDF]

				K. A. Goodman, E. Riedel, V. Serrano, S. Gulati, C. H. Moskowitz, and J. Yahalom Long-Term Effects of High-Dose Chemotherapy and Radiation for Relapsed and Refractory Hodgkin's Lymphoma J. Clin. Oncol., November 10, 2008; 26(32): 5240 - 5247. [Abstract] [Full Text] [PDF]

				S. H. Armenian and S. Bhatia Cardiovascular disease after hematopoietic cell transplantation - lessons learned Haematologica, August 1, 2008; 93(8): 1132 - 1136. [Full Text] [PDF]

				G. Socie Sexuality in long-term survivors Blood, February 1, 2008; 111(3): 972 - 973. [Full Text] [PDF]

				K. L. Syrjala, B. F. Kurland, J. R. Abrams, J. E. Sanders, and J. R. Heiman Sexual function changes during the 5 years after high-dose treatment and hematopoietic cell transplantation for malignancy, with case-matched controls at 5 years Blood, February 1, 2008; 111(3): 989 - 996. [Abstract] [Full Text] [PDF]

				C. Hammond, J. R. Abrams, and K. L. Syrjala Fertility and Risk Factors for Elevated Infertility Concern in 10-Year Hematopoietic Cell Transplant Survivors and Case-Matched Controls J. Clin. Oncol., August 10, 2007; 25(23): 3511 - 3517. [Abstract] [Full Text] [PDF]

				J. R. Fann, C. M. Alfano, S. Roth-Roemer, W. J. Katon, and K. L. Syrjala Impact of Delirium on Cognition, Distress, and Health-Related Quality of Life After Hematopoietic Stem-Cell Transplantation J. Clin. Oncol., April 1, 2007; 25(10): 1223 - 1231. [Abstract] [Full Text] [PDF]

				C. J. Fraser, S. Bhatia, K. Ness, A. Carter, L. Francisco, M. Arora, P. Parker, S. Forman, D. Weisdorf, J. G. Gurney, et al. Impact of chronic graft-versus-host disease on the health status of hematopoietic cell transplantation survivors: a report from the Bone Marrow Transplant Survivor Study Blood, October 15, 2006; 108(8): 2867 - 2873. [Abstract] [Full Text] [PDF]

				E. A. Copelan Hematopoietic stem-cell transplantation. N. Engl. J. Med., April 27, 2006; 354(17): 1813 - 1826. [Full Text] [PDF]