Quality of Life after Allogeneic Hematopoietic Cell Transplantation According to Affected Organ and Severity of Chronic Graft-versus-Host Disease

Saiko Kurosawa, Kumi Oshima, Takuhiro Yamaguchi, Atsumi Yanagisawa, Takahiro Fukuda, Heiwa Kanamori, Takehiko Mori, Satoshi Takahashi, Tadakazu Kondo, Akio Kohno, Koichi Miyamura, Yukari Umemoto, Takanori Teshima, Shuichi Taniguchi, Takuya Yamashita, Yoshihiro Inamoto, Yoshinobu Kanda, Shinichiro Okamoto, Yoshiko Atsuta

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

Knowing the impact of chronic graft-versus-host disease (GVHD) on quality of life (QoL) after allogeneic hematopoietic stem cell transplantation (allo-HCT) by GVHD type and severity is critical for providing care to transplant survivors. We conducted a cross-sectional questionnaire study to examine the relationship between patient-reported QoL as measured by the Medical Outcomes Study 36-Item Short-Form Health Survey, Functional Assessment of Cancer Therapy-Bone Marrow Transplant, and visual analogue scale (VAS) and chronic GVHD defined by the National Institutes of Health (NIH) criteria. Recipients of allo-HCT for hematologic disease between 1995 and 2009 aged ≥ 16 years at transplant and ≥20 years at the time of the survey who were relapse-free were eligible. A total of 1140 pairs of patient and physician questionnaires were included in the analysis. By NIH global severity score, QoL scores in all aspects were significantly lower in patients with higher global and organ-specific severity grades, independent of background variables. Compared with patients without GVHD symptoms, those with mild symptoms had impaired physical and general QoL according to global severity score and organ-specific scores except for the genital tract. Mild symptoms in the lungs, gastrointestinal tract, and joints and fascia were associated with clinically meaningful deterioration of physical QoL. VAS scores provided by physicians were generally higher than those provided by patients. Differences between scores reported by patients and physicians were larger for patients with no or mild GVHD symptoms. Our findings based on more than 1000 long-term survivors after HCT enabled us to identify a target of care, informing survivorship care protocols to improve post-transplantation QoL.

Original languageEnglish
Pages (from-to)1749-1758
Number of pages10
JournalBiology of Blood and Marrow Transplantation
Volume23
Issue number10
DOIs
Publication statusPublished - 2017 Oct

Keywords

  • Allogeneic hematopoietic cell transplantation
  • Graft-versus-host disease
  • Long-term follow-up
  • National Institutes of Health criteria
  • Proxy
  • Quality of life

ASJC Scopus subject areas

  • Hematology
  • Transplantation

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    Kurosawa, S., Oshima, K., Yamaguchi, T., Yanagisawa, A., Fukuda, T., Kanamori, H., Mori, T., Takahashi, S., Kondo, T., Kohno, A., Miyamura, K., Umemoto, Y., Teshima, T., Taniguchi, S., Yamashita, T., Inamoto, Y., Kanda, Y., Okamoto, S., & Atsuta, Y. (2017). Quality of Life after Allogeneic Hematopoietic Cell Transplantation According to Affected Organ and Severity of Chronic Graft-versus-Host Disease. Biology of Blood and Marrow Transplantation, 23(10), 1749-1758. https://doi.org/10.1016/j.bbmt.2017.06.011