Löf C M, Winiarski J, Giesecke A, Ljungman P, Forinder U
Department of Paediatrics, CLINTEC, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
Bone Marrow Transplant. 2009 Mar;43(6):461-8. doi: 10.1038/bmt.2008.338. Epub 2008 Oct 20.
Fifty-three adults who had received SCT as children responded to questionnaires on health-related quality of life (HRQoL) (Swedish HRQoL survey (SWED-QUAL)), sense of coherence (SOC), anxiety and depression (HAD) and a health and symptom inventory. Late effects were classified following the Common Terminology Criteria for Adverse Events (CTCAE) v. 3.0. HRQoL was below norm in 9 of 13 SWED-QUAL domains. Poorest domains (P<0.001) were satisfaction with physical health, general health, partner relations and sexual function, whereas emotional wellbeing and satisfaction with family life were on par with the norm. Older age, time elapsed post-SCT and fewer self-reported symptoms correlated with better HRQoL. Unfavourable late effect scores had no or limited impact, whereas age at SCT or TBI did not adversely affect HRQoL. Most subjects were well subjectively and objectively, whereas 24% had more complicated late effects. The median Karnofsky score was 90, 13% of subjects having scores below 80. In total, 53% reported pain, whereas 42.5% had memory and concentration problems. Anxiety and/or depression, reported by 35%, were associated with lower HRQoL and SOC ratings. Overall, 55% reported infertility and expressed difficulty with this. To conclude, childhood SCT did not negatively affect overall health for most of these adult long-term survivors, although poorer HRQoL with psychological and cognitive problems are common.
53名儿童期接受过造血干细胞移植（SCT）的成年人对有关健康相关生活质量（HRQoL）（瑞典生活质量调查问卷（SWED-QUAL））、连贯感（SOC）、焦虑和抑郁（医院焦虑抑郁量表（HAD））以及健康和症状清单的问卷进行了回答。根据不良事件通用术语标准（CTCAE）第3.0版对迟发效应进行分类。在SWED-QUAL的13个领域中，有9个领域的HRQoL低于正常水平。最差的领域（P<0.001）是对身体健康、总体健康、伴侣关系和性功能的满意度，而情绪健康和对家庭生活的满意度与正常水平相当。年龄较大、SCT后经过的时间较长以及自我报告的症状较少与较好的HRQoL相关。不良的迟发效应评分没有影响或影响有限，而SCT或颅脑照射时的年龄并未对HRQoL产生不利影响。大多数受试者在主观和客观方面情况良好，而24%的受试者有更复杂的迟发效应。卡诺夫斯基评分中位数为90分，13%的受试者评分低于80分。总体而言，53%的受试者报告有疼痛，而42.5%的受试者有记忆和注意力问题。35%的受试者报告有焦虑和/或抑郁，这与较低的HRQoL和SOC评分相关。总体而言，55%的受试者报告有不孕问题，并表示对此感到困难。总之，尽管心理和认知问题导致的较差HRQoL很常见，但儿童期SCT对大多数成年长期存活者的整体健康没有负面影响。
