Longitudinal assessment of symptoms and quality of life: Differences by ablative and non-ablative blood and marrow transplantation

Abstract

6630 Background: Blood and marrow transplantation (BMT) is both widely used and leads to a variety of severe symptoms. The success of BMT, survival, and quality of life (QOL) for patients is related to successful control of symptoms of the transplantation. Symptoms vary by type and stage of disease and by type of preparative regimen and transplantation. Symptoms are also linked with quality of life, although research findings leave much to be understood about that link. Patients in several studies have rated their QOL positively, despite experiencing psychosocial and physical sequelae such as fatigue, anxiety, pain, sexual dysfunction, depression, sleep disturbances, inability to return to work, and fear of relapse or death. It is important to distinguish between symptom prevalence and perceived quality of life and to understand why patients rate QOL positively in spite of symptoms. Methods: Data were collected from 164 patients longitudinally at 8 points from pre-transplant to 100 days post-transplant. Diagnoses included AML/MDS, Hodgkin's, lymphoma, myeloma, 59 (28%) had allogeneic transplant with myeloablative regimen, 64 (31%) had allogeneic with non-myeloablative regimen and 87 (41%) with autologous transplant. Symptom severity and its impact were measured using the M. D. Anderson Symptom Inventory (MDASI) while QOL was assessed using the Functional Assessment of Cancer Therapy for BMT (FACT-BMT). Results: As hypothesized, larger proportion of patients who had allogeneic transplant with myeloablative regimen showed severe symptoms such as fatigue (p<0.02) and pain (p<.03) and poorer quality of life (p<0.001) across time. Symptom severity is significantly correlated with quality of life across time with correlations ranging from –0.59 to -0.75. Conclusions: Type of transplant and prepatory regimen are both important aspects to consider when managing symptoms and quality of life. Additional measures may be needed for patients with myeloablative regimens and allogeneic transplants. No significant financial relationships to disclose.