Amin E N, Phillips G S, Elder P, Jaglowski S, Devine S M, Wood K L
Division of Pulmonary, Department of Medicine, Critical Care and Sleep Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
The Ohio State University Center for Biostatistics, Columbus, OH, USA.
Bone Marrow Transplant. 2015 Feb;50(2):289-95. doi: 10.1038/bmt.2014.264. Epub 2014 Nov 24.
Bronchiolitis obliterans syndrome (BOS) remains an important complication following allo-SCT. The development of this condition portends a higher morbidity and mortality but the effect on heath-related quality of life (HRQL) is unknown. The aim of this study was to determine whether the development of BOS impacted HRQL compared with patients without BOS. This Institutional Review Board-approved prospective study analyzed 126 patients who underwent allo-SCT at our institution. Patients were administered three HRQL survey tools (SF-36, European Organization for Research and Treatment of Cancer QLQ-c30 and St George Respiratory Questionnaire (SGRQ)) before transplant and then again at 6 months, 1 year and 2 years after transplant. Patients were analyzed in three groups determined by highest chronic GVHD (cGVHD) severity and BOS status. Overall, our study group had improving HRQL after transplant when measured over time, measured by the SF-36 with stable HRQL, when measured by the SGRQ total score and QLQ-c30. Patients that developed BOS had significantly worse HRQL scores measured by the SGRQ and the SF-36 physical composite score. This difference was not explained by the severity of cGVHD that patients with BOS developed.
闭塞性细支气管炎综合征(BOS)仍然是异基因造血干细胞移植(allo-SCT)后的一个重要并发症。这种疾病的发生预示着更高的发病率和死亡率,但对健康相关生活质量(HRQL)的影响尚不清楚。本研究的目的是确定与未发生BOS的患者相比,BOS的发生是否会影响HRQL。这项经机构审查委员会批准的前瞻性研究分析了在我们机构接受allo-SCT的126例患者。患者在移植前接受了三种HRQL调查工具(SF-36、欧洲癌症研究与治疗组织QLQ-c30和圣乔治呼吸问卷(SGRQ))的评估,然后在移植后6个月、1年和2年再次进行评估。根据最高慢性移植物抗宿主病(cGVHD)严重程度和BOS状态将患者分为三组进行分析。总体而言,随着时间的推移,我们的研究组在移植后的HRQL有所改善,通过SF-36测量时HRQL稳定,通过SGRQ总分和QLQ-c30测量时也是如此。发生BOS的患者通过SGRQ和SF-36身体综合评分测量的HRQL得分明显更差。BOS患者发生的cGVHD严重程度并不能解释这种差异。