PB2338: QUALITY OF LIFE AFTER ALLOGENIC HEMATOPOIETIC STEM CELL TRANSPLANTATION: IMPACT OF CHRONIC GVHD

Abstract

Background: Hematopoietic Stem Cell transplantation (HSCT) is a potentially curative treatment for several hematological diseases, but it is often complicated by significant morbidity and mortality. This is particularly related to chronic Graft versus Host Disease (GVHD) that can deeply impact patients’ quality of life (QoL). Aims: Our purpose was to evaluate patients’QoL after HSCT and to clarify the impact of chronic GVHD. Methods: We conducted a cross-sectional descriptive study at the National Bone Marrow Transplant Center including patients who underwent HSCT between January 2018 and December 2019. These patients filled in the questionnaire for the quantitative measurement of quality of life using 36-Item Short-Form Health Survey (SF-36) and to the Functional Assessement of Cancer Therapy-Bone Marrow Transplantation (FACT-BMT) during a phone interview. Results: Of the 52 patients still alive at the time of the survey, 43 patients were contactable and willing to participate (participation rate: 83%). The median age of the participants was 28 years (7-52) with a sex ratio of 1.52. Underlying disease was acute leukemia for 29 patients and aplastic anemia for 14 others. The median time between HSCT and the interview was of 26 months (17-39). At the time of the survey, all patients were in complete remission and 28% among them (12 of 43) had active extensive chronic GVHD. Results obtained in the different dimensions of the SF-36 and FACT-BMT scales indicated good overall QoL in patients after HSCT. However, using SF-36, patients with chronic active GVHD had significantly lower scores on « role limitation due to their physical condition » (p=0.001), «role limitation due to their psychological condition » (p=0.0001), « vitality » (p= 0.045) and « general health perception » (p=0.027) than the other patients. In addition, the FACT-BMT score revealed a negative impact on chronic GVHD in physical well-being dimension (p=0.009) and the functional well-being dimension (p=0.027). Apart from chronic active GVHD, a negative impact on QoL was noted with: adult age, peripheral stem cells transplants and GVHD prophylaxis with ciclosporin alone. Summary/Conclusion: Active chronic GVHD was associated with impared QoL in patients after HSCT hence the need for rapid diagnosis and optimal prophylaxis and treatment of this complication.