Moffitt Cancer Center, Tampa, FL, USA.
Blood. 2011 Apr 28;117(17):4651-7. doi: 10.1182/blood-2010-11-319509. Epub 2011 Feb 25.
Quality of life (QOL) after hematopoietic cell transplantation (HCT) is compromised by chronic GVHD. In a prospectively assembled multicenter cohort of adults with chronic GVHD (n = 298), we examined the relationship between chronic GVHD severity defined by National Institutes of Health (NIH) criteria and QOL as measured by the SF-36 and FACT-BMT instruments at time of enrollment. Chronic GVHD severity was independently associated with QOL, adjusting for age. Compared with population normative data, SF-36 scores were more than a SD (10 points) lower on average for the summary physical component score (PCS) and role-physical subscale, and significantly lower (with magnitude 4-10 points) for several other subscales. Patients with moderate and severe cGVHD had PCS scores comparable with scores reported for systemic sclerosis, systemic lupus erythematosus, and multiple sclerosis, and greater impairment compared with common chronic conditions including diabetes, hypertension, and chronic lung disease. Moderate to severe cGVHD as defined by NIH criteria is associated with significant compromise in multiple QOL domains, with PCS scores in the range of other systemic autoimmune diseases. Compromised QOL provides a functional assessment of the effects of chronic GVHD, and may be measured in cGVHD clinical studies using either the SF-36 or the FACT-BMT.
造血细胞移植(HCT)后生活质量(QOL)因慢性移植物抗宿主病(cGVHD)而受损。在一项前瞻性、多中心的慢性 GVHD 成人队列研究中(n = 298),我们研究了 NIH 标准定义的慢性 GVHD 严重程度与 SF-36 和 FACT-BMT 仪器在入组时测量的 QOL 之间的关系。慢性 GVHD 严重程度与 QOL 独立相关,校正年龄后。与人群参考值相比,SF-36 总分的生理成分评分(PCS)和身体角色维度的平均得分低了一个标准差(10 分),其他几个维度的得分明显较低(幅度为 4-10 分)。中重度 cGVHD 患者的 PCS 评分与系统性硬化症、系统性红斑狼疮和多发性硬化症的评分相当,且与糖尿病、高血压和慢性肺病等常见慢性疾病相比,损伤程度更大。NIH 标准定义的中重度 cGVHD 与多个 QOL 领域的显著受损有关,PCS 评分与其他系统性自身免疫性疾病相当。受损的 QOL 提供了慢性 GVHD 影响的功能评估,并且可以使用 SF-36 或 FACT-BMT 在 cGVHD 临床研究中进行测量。