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异基因造血干细胞移植后青少年和青年的身体及心理社会状况:一项前瞻性多中心试验的结果

Physical and psychosocial aspects of adolescent and young adults after allogeneic hematopoietic stem-cell transplantation: results from a prospective multicenter trial.

作者信息

Pulewka Kristin, Wolff Daniel, Herzberg Philipp Y, Greinix Hildegard, Heussner Pia, Mumm Friederike H A, von Harsdorf Stephanie, Rieger Kathrin, Hemmati Philipp, Hochhaus Andreas, Hilgendorf Inken

机构信息

Institute of Psychosocial Medicine and Psychotherapy, University Hospital Jena, Jena, Germany.

Klinik für Innere Medizin II, Abteilung Hämatologie und Internistische Onkologie, Universitätsklinikum Jena, Am Klinikum 1, 07740, Jena, Germany.

出版信息

J Cancer Res Clin Oncol. 2017 Aug;143(8):1613-1619. doi: 10.1007/s00432-017-2424-4. Epub 2017 Apr 19.

DOI:10.1007/s00432-017-2424-4
PMID:28424902
Abstract

PURPOSE

Allogeneic hematopoietic stem-cell transplantation (alloHSCT) is physically and psychosocially demanding. Among transplant recipients, adolescent and young adults (AYA) represent a special group, as disease occurs early in life, resulting in the prospect of long survival time and high burden of alloHSCT sequelae. However, data focusing on AYA undergoing alloHSCT are rare.

METHODS

Data resulting from a prospective multicenter trial initially focusing on graft-versus-host disease (GvHD) after alloHSCT were reused to analyse the differences between AYA and elderly patients. In total, data of 205 alloHSCT recipients were evaluated. Patients completed the FACT-BMT, HAP, SF-36, 24-AM, LOT-R, BSSS, HADS, and GvHD questionnaires.

RESULTS

Median age of AYA and non-AYA patients was 29 and 52 years. Using 24-AM-Test, evaluating personality traits, non-AYA reported to be more conscientious (p = 0.033). However, AYA described higher quality of life regarding physical role functioning (p = 0.001), physical functioning (p = 0.002), bodily pain (p = 0.023), and emotional role function (p = 0.027) in the SF-36. General health perception, vitality, social role functioning, and mental health were comparable among both groups. On HAP scale, AYA reported higher maximum (p = 0.003) and adjusted activity scores (p = 0.002), but showed similar restrictions regarding activity, self-supply, and self-determination.

CONCLUSION

AYA represent a particular group characterized by higher physical well-being and activity scores, and significantly vary from non-AYA patients in psychosocial aspects. Studies covering distinctive features of AYA undergoing alloHSCT are warranted to improve awareness of the special needs of this group.

摘要

目的

异基因造血干细胞移植(alloHSCT)对身体和心理社会方面的要求都很高。在移植受者中,青少年和青年(AYA)是一个特殊群体,因为疾病在生命早期发生,导致生存时间长且alloHSCT后遗症负担重。然而,关注接受alloHSCT的AYA的数据很少。

方法

一项最初关注alloHSCT后移植物抗宿主病(GvHD)的前瞻性多中心试验所产生的数据被重新用于分析AYA与老年患者之间的差异。总共评估了205名alloHSCT受者的数据。患者完成了FACT - BMT、HAP、SF - 36、24 - AM、LOT - R、BSSS、HADS和GvHD问卷。

结果

AYA患者和非AYA患者的中位年龄分别为29岁和52岁。使用24 - AM测试评估人格特质时,非AYA患者报告更有责任心(p = 0.033)。然而,在SF - 36中,AYA在身体角色功能(p = 0.001)、身体功能(p = 0.002)、身体疼痛(p = 0.023)和情感角色功能(p = 0.027)方面描述了更高的生活质量。两组在总体健康感知、活力、社会角色功能和心理健康方面相当。在HAP量表上,AYA报告了更高的最大(p = 0.003)和调整后的活动得分(p = 0.002),但在活动、自我供给和自主方面显示出类似的限制。

结论

AYA是一个特殊群体,其特点是身体幸福感和活动得分较高,并且在心理社会方面与非AYA患者有显著差异。有必要开展涵盖接受alloHSCT的AYA独特特征的研究,以提高对该群体特殊需求的认识。

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