Andorsky D J, Loberiza F R, Lee S J
Department of Medicine, Brigham and Women's Hospital, Boston, MA 02115, USA.
Bone Marrow Transplant. 2006 May;37(9):889-95. doi: 10.1038/sj.bmt.1705347.
Previous studies of quality of life (QOL) note compromised QOL after stem cell transplantation (HCT), but do not usually consider the impact of pre-transplantation deficits in QOL on post transplantation outcomes. To examine these associations, multivariate models for six self-reported QOL outcomes at 6 and 12 months were constructed, considering pre-transplantation clinical status and QOL, and subsequent clinical events. Outcomes measured overall subjective health, social functioning and agreement with statements such as 'Life has returned to normal.' Of 320 autologous and allogeneic HCT recipients who completed pre-transplantation surveys, 197 completed 6-month surveys and 175 completed 12-month surveys. Pre-transplantation overall health and mental health were independent predictors of all QOL outcomes at 6 months. Baseline physical health was also predictive of four of six outcomes at 12 months. In contrast, disease risk was predictive only of enjoying normal activities at 6 months. Relapse and chronic graft-versus-host disease were associated with poorer QOL. In conclusion, pre-transplantation self-reported physical and mental health are more strongly associated with QOL after HCT than commonly noted baseline clinical predictors such as age and disease risk. Measurement of baseline QOL can help place the effects of the transplantation procedure in context.
以往关于生活质量（QOL）的研究指出，干细胞移植（HCT）后生活质量会受到损害，但通常未考虑移植前生活质量缺陷对移植后结果的影响。为了研究这些关联，构建了6个月和12个月时6项自我报告的生活质量结果的多变量模型，同时考虑了移植前的临床状况和生活质量以及随后的临床事件。这些结果衡量了总体主观健康状况、社会功能以及对诸如“生活已恢复正常”等陈述的认同度。在320名完成移植前调查的自体和异体HCT受者中，197人完成了6个月的调查，175人完成了12个月的调查。移植前的总体健康和心理健康是6个月时所有生活质量结果的独立预测因素。基线身体健康状况也是12个月时6项结果中4项的预测因素。相比之下，疾病风险仅在6个月时对享受正常活动有预测作用。复发和慢性移植物抗宿主病与较差的生活质量相关。总之，移植前自我报告的身心健康与HCT后的生活质量的关联比年龄和疾病风险等常见的基线临床预测因素更为紧密。测量基线生活质量有助于了解移植手术的影响。
