Assessment of symptom burden in patients undergoing autologous stem cell transplantation
Journal
Bone Marrow Transplantation Journal
Date Issued
2011
Author(s)
DOI
10.1038/bmt.2011.48
Abstract
Patients who undergo autologous peripheral blood stem cell
(PBSC) transplantation experience multiple symptoms that affect quality of life. We assessed symptoms during the fi rst
30 days during and after autologous PBSC transplantation to
determine the severity of individual symptoms and to determine
overall symptom profi les in 120 patients with lymphoid malignancies
that underwent autologous transplantation in our center.
Eligible patients were at least 18 years of age, spoke maternal
language, and could see and hear well enough to complete
the assessment measures. The assessment of symptoms was
measured according to the MD Anderson recommendations of
14 symptom profi ling, as well as correlated with the patient’s
laboratory fi ndings, ECOG score and the profi le of mood states
(POMS). We retrospectively evaluated if hematopoietic cell
transplantation comorbidity index (HCT-CI), karnofsky performance
status (PS) and other readily available pretransplant
variables concerning pretransplant mobilization strategies that
can also predict the outcome of autologous recipients in our
transplant center. HCT-CI risk was low in 10 (12%), intermediate
in 22 (27%) high in 45 (55%) and undetermined in 5 (6%).
Two year OS was 45% (95%CI: 24-64%), 55% (95%CI: 40-
68%) and 42% (95%CI: 24-64%) in the low, intermediate and
high-risk HCT-CI groups respectively. The repeated measures
ANOVA for symptom severity scores (P<0.001) and symptom
interference scores (P<0.001) showed only a main effect for
time. None of the potential covariates (demographics, mood,
quality of life, cancer diagnosis, treatment-related variables
and laboratory measures) were signifi cant. Fatigue severity
revealed a signifi cant time-by-cancer-diagnosis interaction
(P=0.048), as well as pain severity (P=0.008). Sleep disturbance
and lack of appetite revealed a signifi cant time interaction
(P=0.02). The symptom patterns over time demonstrated
by patients with non-Hodgkin’s lymphoma differed from those
shown by patients with multiple myeloma. Future research can
also identify differing clusters of symptoms in subgroups of
patients who undergo stem cell transplantation.
(PBSC) transplantation experience multiple symptoms that affect quality of life. We assessed symptoms during the fi rst
30 days during and after autologous PBSC transplantation to
determine the severity of individual symptoms and to determine
overall symptom profi les in 120 patients with lymphoid malignancies
that underwent autologous transplantation in our center.
Eligible patients were at least 18 years of age, spoke maternal
language, and could see and hear well enough to complete
the assessment measures. The assessment of symptoms was
measured according to the MD Anderson recommendations of
14 symptom profi ling, as well as correlated with the patient’s
laboratory fi ndings, ECOG score and the profi le of mood states
(POMS). We retrospectively evaluated if hematopoietic cell
transplantation comorbidity index (HCT-CI), karnofsky performance
status (PS) and other readily available pretransplant
variables concerning pretransplant mobilization strategies that
can also predict the outcome of autologous recipients in our
transplant center. HCT-CI risk was low in 10 (12%), intermediate
in 22 (27%) high in 45 (55%) and undetermined in 5 (6%).
Two year OS was 45% (95%CI: 24-64%), 55% (95%CI: 40-
68%) and 42% (95%CI: 24-64%) in the low, intermediate and
high-risk HCT-CI groups respectively. The repeated measures
ANOVA for symptom severity scores (P<0.001) and symptom
interference scores (P<0.001) showed only a main effect for
time. None of the potential covariates (demographics, mood,
quality of life, cancer diagnosis, treatment-related variables
and laboratory measures) were signifi cant. Fatigue severity
revealed a signifi cant time-by-cancer-diagnosis interaction
(P=0.048), as well as pain severity (P=0.008). Sleep disturbance
and lack of appetite revealed a signifi cant time interaction
(P=0.02). The symptom patterns over time demonstrated
by patients with non-Hodgkin’s lymphoma differed from those
shown by patients with multiple myeloma. Future research can
also identify differing clusters of symptoms in subgroups of
patients who undergo stem cell transplantation.
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