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接受干细胞移植治疗的患者在1年后的健康相关生活质量与普通人群相当吗?

Do patients who are treated with stem cell transplantation have a health-related quality of life comparable to the general population after 1 year?

作者信息

Hjermstad M, Holte H, Evensen S, Fayers P, Kaasa S

机构信息

The Norwegian Cancer Society, Oslo, Norway.

出版信息

Bone Marrow Transplant. 1999 Oct;24(8):911-8. doi: 10.1038/sj.bmt.1701998.

Abstract

Health-related quality of life (HRQOL) in leukemia and lymphoma patients treated with high-dose chemotherapy followed by allogeneic (SCT) and autologous (ASCT) stem cell transplantation or receiving combination chemotherapy (CT) was prospectively assessed by the EORTC QLQ-C30 and compared with reference data from a general population sample. One year after transplant, the SCT group had functional scores which were close to population values except for lower social (P < 0.0001) and role function (P = 0.0004). More symptoms and problems were reported, especially appetite loss (P = 0. 001) and financial difficulties (P = 0.0001). The ASCT patients reported a less than optimal HRQOL relative to the population 1 year post transplant. Cognitive, physical, role, and social function, dyspnoea, financial difficulties and global quality of life were most impaired (P < 0.001). In the CT group, physical, role and social function, dyspnoea and financial difficulties were impaired 1 year after start of chemotherapy, compared with the general population (P < 0.001). The EORTC QLQ-C30 was supplemented by a high-dose chemotherapy module, the HDC-19, at the 1-year assessment, but no consistent differences were found across groups. Fifteen to 34% of the patients expressed fears of relapse and worries about future health, while 24-30% indicated no participation in sexual activities.

摘要

采用欧洲癌症研究与治疗组织(EORTC)的QLQ-C30量表,对接受大剂量化疗后行异基因(SCT)和自体(ASCT)干细胞移植或接受联合化疗(CT)的白血病和淋巴瘤患者的健康相关生活质量(HRQOL)进行了前瞻性评估,并与来自普通人群样本的参考数据进行了比较。移植后一年,SCT组的功能评分除社会功能(P<0.0001)和角色功能(P = 0.0004)较低外,接近人群值。报告的症状和问题更多,尤其是食欲减退(P = 0.001)和经济困难(P = 0.0001)。ASCT患者在移植后1年报告的HRQOL相对于人群不理想。认知、身体、角色和社会功能、呼吸困难、经济困难和总体生活质量受损最严重(P<0.001)。在CT组中,与普通人群相比,化疗开始1年后身体、角色和社会功能、呼吸困难和经济困难受损(P<0.001)。在1年评估时,EORTC QLQ-C30量表由一个大剂量化疗模块HDC-19补充,但各组之间未发现一致差异。15%至34%的患者表示担心复发和对未来健康的担忧,而24%至30%的患者表示不参与性活动。

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