Watson M, Buck G, Wheatley K, Homewood J R, Goldstone A H, Rees J K H, Burnett A K
Psychological Medicine, Royal Marsden Hospital NHS Trust, Sutton & London & Institute of Cancer Research, Downs Road, Sutton, Surrey SM2 5PT, UK.
Eur J Cancer. 2004 May;40(7):971-8. doi: 10.1016/S0959-8049(03)00628-2.
The increasing success of intensive consolidation chemotherapy (CCT) as an alternative to bone marrow transplant (BMT) in acute myeloid leukaemia (AML) necessitates comparison of the impact on quality of life (QoL) of these two treatment modalities. Most QoL studies following BMT involve small patient numbers and provide ambivalent results. The present study examines QoL in a large number of patients 1 year from the end of treatment within the United Kingdom Medical Research Council (UK MRC) AML10 trial of BMT versus CCT. Allogeneic-BMT (Allo-BMT) was observed to have an adverse impact on most QoL dimensions compared with Autologous-BMT (A-BMT) and CCT. More patients receiving BMT had mouth dryness problems and worse sexual and social relationships, professional and leisure activities than CCT patients. QoL in A-BMT patients was less impacted than Allo-BMT. Intention-to-treat analysis showed similar results. These results indicate that a reconsideration of treatment strategies is warranted, and that further, good prospective studies are needed to evaluate more clearly the effects of these treatments in long-term survivors.
在急性髓系白血病（AML）中，强化巩固化疗（CCT）作为骨髓移植（BMT）的替代方案越来越成功，因此有必要比较这两种治疗方式对生活质量（QoL）的影响。大多数骨髓移植后的生活质量研究涉及的患者数量较少，结果也模棱两可。本研究在英国医学研究委员会（UK MRC）针对骨髓移植与强化巩固化疗的AML10试验中，对大量患者治疗结束1年后的生活质量进行了研究。与自体骨髓移植（A-BMT）和强化巩固化疗相比，异基因骨髓移植（Allo-BMT）被观察到对大多数生活质量维度有不利影响。与接受强化巩固化疗的患者相比，接受骨髓移植的患者有更多口干问题，性和社会关系、职业和休闲活动方面也更差。自体骨髓移植患者的生活质量受影响程度低于异基因骨髓移植患者。意向性分析显示了类似结果。这些结果表明有必要重新考虑治疗策略，并且需要进一步开展良好的前瞻性研究，以更清楚地评估这些治疗方法对长期存活者的影响。
