Abstract
Background: The study of the quality of life (QoL) in patients after allo-Haematopoietic Stem Cell Transplantation (allo-HSCT) is necessary in order to evaluate results, give more accurate information to the patients and help us with the implementation of new strategies that improve the QoL of these patients. Aims: We aim to evaluate the impact of allo-HSCT and graft versus host disease (GvHD) on QoL of patients. Methods: Our series consisted of 29 patients who received an allo-HSCT between 1996 and 2017 at our hospital. To evaluate the QoL we used the validated questionnaires of QoL SF-36, FACT-BMT (version 4) and a self-made questionnaire. We used IBM SPSS v.23 to determine univariate analysis of variance, binary logistic regression and chi squared. p value <0.05 was considered as statistically significant. Results: We contacted with 64 patients but only 29 accepted to participate on the study. On table 1 are the demographic and clinical features related to the allo-HSCT and GvHD. Regarding the SF-36 questionnaire we found a correlation between obtaining a punctuation over 70% on physical state and having a job when the questionnaire was completed (p = 0.027). When we analyzed the QoL with FACT-BMT we observed that patients transplanted less than 2 years ago presented a worse QoL than those transplanted 2 or more years ago (p = 0.001), but did not observe this statistically significant difference with SF-36. We found that patients with a low result for mental state under SF-36 show a worse QoL measured by FACT-BMT (p = 0.004). On the sub-scales analysis we found a statistically significant relation between patients with hepatic chronic GvHD and a decrease on the physical well-being (p = 0.035) and functional well-being (p = 0.006) measured with FACT-BMT. We also observed a lower punctuation on functional well-being for patients with ocular (p = 0.015), cutaneous (p = 0.016) and hepatic (p = 0.006) chronic GvHD. We observed that 44.8% of patients presented sexual symptoms of which 10.3% described pain, what could suggest the presence of genital GvHD. We found no statistically significant correlation between the result of SF-36 and FACT-BMT.Summary/Conclusion: There is a negative impact on QoL of patients with hepatic and digestive chronic GvHD. McQuellon et al in 1198 reported that the recovery path of transplanted patients present a parabolic tendency improving after day 100. We observed a worse QoL by FACT-BMT on patients being on the 2 years post-HSCT. This suggests that the first years post-transplant is when the evaluation of the quality of life could bring more benefit to patients. When comparing the two tests used FACT-BMT (version 4) and SF-36, no statistically significant relationship was found between the results of both, which suggests that the application of a single test may be insufficient when assessing the patient's integral form. Allo-HSCT impacts on a negatively on QoL of patients, especially on those developing GvHD and we need to develop new tools allowing us to evaluate globally the patients.
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