Liang Yongchun, Wang Haifang, Niu Meie, Zhu Xiaming, Cai Jianzheng, Wang Xiubei
a Department of Nursing , The First Affiliated Hospital of Soochow University , Suzhou , Jiangsu , People's Republic of China.
b Department of Hematology , The First Affiliated Hospital of Soochow University , Suzhou , Jiangsu , People's Republic of China.
Hematology. 2018 Oct;23(9):626-632. doi: 10.1080/10245332.2018.1457199. Epub 2018 Mar 27.
The aim of our longitudinal study was to explore changes in HRQOL over a 6-month period and to identify factors associated with the HRQOL of HSCT recipients.
Our study comprised 191 HSCT patients; their data were collected before transplantation and at 30, 90, and 180 days posttransplantation. The Functional Assessment of Cancer Therapy-Bone Marrow Transplant (FACT-BMT) questionnaire was used to assess HRQOL.We also evaluated the patients' demographic characteristics and clinical histories to determine the relative contributions of these factors to HRQOL outcomes.
Before HSCT, the patients reported a mean overall HRQOL of 110.31 (SD, 14.99); this reached a minimum of 105.07 (SD, 18.85) at day 30 after HSCT and increased steadily over time to 106.71 (SD, 18.34) at day 90 and 108.16 (SD, 18.34) at day 180 after HSCT.Compared with baseline, overall HRQOL changed with the mean of -5.24 (SE 1.55; P = .001), and -3.60 (SE 1.55; P = .022), respectively, at 30 days and 90 days after HSCT. Overall HRQOL returned to near pretransplant levels at 180 days after HSCT (SE 1.47; P = .146).Generalized estimating equation (GEE) models showed that household income (β = 6.590; P < .001), transplant-related complications (β = -6.101; P < .001), and patient age (β = 0.243, P = .045) were associated with HRQOL.
The patients' overall HRQOL was severely impaired in the early stages of posttransplantation, and patients experienced the worst HRQOL at 30 days. They had improved significantly by 180 days posttransplantation. We also found that household income, transplant-related complications, and age were independent predictors of early HRQOL.We therefore concluded that the HRQOL of HSCT patients in the early stages posttransplantation deserved more attention.
我们这项纵向研究的目的是探讨造血干细胞移植（HSCT）受者在6个月期间健康相关生活质量（HRQOL）的变化，并确定与HRQOL相关的因素。
我们的研究纳入了191例HSCT患者；在移植前以及移植后30天、90天和180天收集他们的数据。采用癌症治疗功能评估-骨髓移植（FACT-BMT）问卷来评估HRQOL。我们还评估了患者的人口统计学特征和临床病史，以确定这些因素对HRQOL结果的相对影响。
在HSCT前，患者报告的平均总体HRQOL为110.31（标准差，14.99）；在HSCT后30天降至最低，为105.07（标准差，18.85），并随时间稳步上升，在HSCT后90天为106.71（标准差，18.34），180天为108.16（标准差，18.34）。与基线相比，HSCT后30天和90天总体HRQOL的变化均值分别为-5.24（标准误1.55；P = 0.001）和-3.60（标准误1.55；P = 0.022）。HSCT后180天总体HRQOL恢复到接近移植前水平（标准误1.47；P = 0.146）。广义估计方程（GEE）模型显示家庭收入（β = 6.590；P < 0.001）、移植相关并发症（β = -6.101；P < 0.001）和患者年龄（β = 0.243，P = 0.045）与HRQOL相关。
患者的总体HRQOL在移植后早期严重受损，在30天时HRQOL最差。到移植后180天时显著改善。我们还发现家庭收入、移植相关并发症和年龄是早期HRQOL的独立预测因素。因此，我们得出结论，HSCT患者移植后早期的HRQOL值得更多关注。
