Health-related quality of life and symptom distress in patients prior to allogeneic stem cell transplant

Abstract

Objective: This study examined health-related quality of life (HRQL) and symptom distress (SD) in patients preparing to undergo allogeneic stem-cell transplant (A-SCT) for the treatment of hematological diseases. Methods: Prospective survey of patients enrolled in an A-SCT clinical trial. HRQL was measured by the physical (PCS) and mental (MCS) health scores of the Short Form-36 (norm = 50) and the Functional Assessment of Cancer Therapy-General (FACT-G; range 0–100). SD was measured by the Symptom Distress Scale (SDS; range 13–65). Patients completed the questionnaires in English or Spanish via a touch-screen computer during the trial baseline period. Scores were compared to published references for the 1998 general United States (US) population (GP) and a cancer population (CP) using one sample t-tests. Scores were also grouped by gender and compared to the male/female GP using one sample t-tests. A p-value <0.05 was considered significant. Findings: Patients (N = 76) were mostly male (67%), ranging in age from 18–71 years (M = 40; SD = 14), and either Caucasian (46%) or Hispanic (30%). Most (97%) had ECOG ≤1. Baseline results demonstrated mean PCS and MCS scores of pre-A-SCT patients were significantly lower than the GP (norm = 50 vs. 43, p < 0.001 and 47, p = 0.015, respectively). The mean PCS score for male patients was significantly lower than male GP (norm = 51 vs. 42; p < 0.001); mean MCS score did not differ (norm = 51 vs. 49; p = 0.20). For female patients, the mean MCS score was significantly lower than female GP (norm = 50 vs. 43; p = .017); mean PCS score did not differ (norm 49 vs. 44; p = 0.05). FACT-G total score was significantly lower than patients with Hodgkin’s Disease (59 vs. 66; p < 0.001). SDS scores (76%) indicated low SD (<25); 24% indicated moderate distress (range 25–32). Conclusion: Patients with hematological diseases, ECOG ≤1, prior to A-SCT have poorer HRQL compared to the US GP and a cancer population, with relatively low levels of SD. Men report more concerns related to physical health compared to men in the GP. Women report more concerns related to mental health compared to women in the GP.