Miller Steve, Sharda Shalini, Rodrigue James, Mehta Paulette
Department of Pediatrics, University of Florida College of Medicine, Gainesville, Florida, USA.
Int J Hematol. 2002 Nov;76(4):365-9. doi: 10.1007/BF02982698.
Thalidomide is being increasingly used after stem cell transplantation as immunosuppression for patients with chronic graft-versus-host disease, as well as for antiangiogenesis effects in patients with multiple myeloma, brain tumors, leukemia, or other malignancies. The goal of this study was to determine if thalidomide improved the quality of life by virtue of its associated sleep-promoting, anxiety-reducing, antiwasting, and antidiarrheal effects. We therefore studied 28 patients with resistant chronic graft-versus-host disease who were treated with thalidomide (13 patients) or other immunosuppressive drugs (15) and compared them with healthy control subjects (16). All patients completed quality-of-life questionnaires prospectively before beginning regimens of thalidomide or other immunosuppressive drugs and completed similar questionnaires at 3- and 6-month intervals thereafter. The Transplant Symptom Frequency score was similar for healthy control subjects and both groups of patients with chronic graft-versus-host disease, regardless of whether they had received thalidomide or not. Quality of sleep was equally poor in patients who received or did not receive thalidomide. The most common complaint of patients with chronic graft-versus-host disease was fatigue, followed in frequency by overeating. The control group had similar concerns. This pilot study suggests that patients with chronic graft-versus-host disease have a quality of life similar to that of their health care workers, regardless of whether they are treated with thalidomide or other immunosuppressive drug, and that fatigue and overeating are the most common complaints.
沙利度胺在干细胞移植后越来越多地被用作慢性移植物抗宿主病患者的免疫抑制剂，以及用于多发性骨髓瘤、脑肿瘤、白血病或其他恶性肿瘤患者的抗血管生成作用。本研究的目的是确定沙利度胺是否因其促进睡眠、减轻焦虑、抗消瘦和止泻作用而改善生活质量。因此，我们研究了28例难治性慢性移植物抗宿主病患者，其中13例接受沙利度胺治疗，15例接受其他免疫抑制药物治疗，并将他们与健康对照者（16例）进行比较。所有患者在开始沙利度胺或其他免疫抑制药物治疗方案前前瞻性地完成生活质量问卷，并在之后的3个月和6个月间隔完成类似问卷。无论是否接受沙利度胺治疗，健康对照者和两组慢性移植物抗宿主病患者的移植症状频率评分相似。接受或未接受沙利度胺治疗的患者睡眠质量同样较差。慢性移植物抗宿主病患者最常见的抱怨是疲劳，其次是暴饮暴食。对照组也有类似的问题。这项初步研究表明，慢性移植物抗宿主病患者的生活质量与医护人员相似，无论他们接受沙利度胺还是其他免疫抑制药物治疗，疲劳和暴饮暴食是最常见的抱怨。
