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人类白细胞抗原半相合与其他异基因造血干细胞移植受者在健康相关生活质量、心理状态和身体功能方面的早期差异。

Early-phase differences in health-related quality of life, psychological status, and physical function between human leucocyte antigen-haploidentical and other allogeneic haematopoietic stem cell transplantation recipients.

作者信息

Morishita Shinichiro, Kaida Katsuji, Yamauchi Shinya, Wakasugi Tatsushi, Ikegame Kazuhiro, Kodama Norihiko, Ogawa Hiroyasu, Domen Kazuhisa

机构信息

Department of Rehabilitation, Hyogo College of Medicine Hospital, Nishinomiya, Japan.

Division of Haematology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan.

出版信息

Eur J Oncol Nurs. 2015 Oct;19(5):443-50. doi: 10.1016/j.ejon.2015.02.002. Epub 2015 Apr 21.

DOI:10.1016/j.ejon.2015.02.002
PMID:25911269
Abstract

PURPOSE

This study investigated the differences between allogeneic haematopoietic stem cell transplantation (allo-HSCT) patients receiving HSC from human leucocyte antigen (HLA)-haploidentical donors (HID) and other donors that included HLA-matched sibling, matched unrelated, and unrelated umbilical cord blood donors in the 6 weeks after HSCT with respect to quality of life (QOL), psychological status, and physical function.

METHODS

The study included 126 patients (HID group, n = 100; other donor group, n = 26) who underwent allo-HSCT between July 2007 and December 2012. Patients were evaluated for health-related QOL using the Medical Outcome Study 36-item Short Form Health Survey. Psychological status was measured by Hospital Anxiety and Depression Scale. Physical function was assessed using tests for handgrip strength, knee extensor strength, and the 6-min walk test.

RESULTS

After HSCT, the HID group showed significantly greater improvements in the general health subscale and Mental Component Summary (MCS) of QOL than the other donor group (P < 0.01). Multivariate analysis confirmed that complete remission and age were associated with changes in the general health subscale before and after HSCT (P < 0.05). With regard to physical function, the HID group showed significantly more decline than the other donor group with respect to handgrip strength and knee extensor muscle strength after HSCT (P < 0.05). Total corticosteroid dose was associated with decreased handgrip strength before and after HSCT (P < 0.05).

CONCLUSIONS

The donor type affects QOL, psychological status, and physical function in allo-HSCT recipients; these findings may provide insights for customised rehabilitation strategies for HSCT recipients.

摘要

目的

本研究调查了接受人类白细胞抗原(HLA)单倍体相合供者(HID)造血干细胞(HSC)的异基因造血干细胞移植(allo-HSCT)患者与接受其他供者(包括HLA匹配的同胞供者、匹配的无关供者和无关脐血供者)的allo-HSCT患者在HSCT后6周内生活质量(QOL)、心理状态和身体功能方面的差异。

方法

该研究纳入了2007年7月至2012年12月期间接受allo-HSCT的126例患者(HID组,n = 100;其他供者组,n = 26)。使用医学结局研究36项简式健康调查对患者的健康相关QOL进行评估。通过医院焦虑抑郁量表测量心理状态。使用握力测试、膝伸肌力量测试和6分钟步行测试评估身体功能。

结果

HSCT后,HID组在QOL的总体健康子量表和心理成分总结(MCS)方面的改善明显大于其他供者组(P < 0.01)。多变量分析证实,完全缓解和年龄与HSCT前后总体健康子量表的变化相关(P < 0.05)。在身体功能方面,HSCT后HID组在握力和膝伸肌力量方面的下降明显多于其他供者组(P < 0.05)。总皮质类固醇剂量与HSCT前后握力下降相关(P < 0.05)。

结论

供者类型影响allo-HSCT受者的QOL、心理状态和身体功能;这些发现可能为HSCT受者的定制康复策略提供见解

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