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异基因造血干细胞移植后幸存者的晚期并发症和生活质量评估。

Late complications and quality of life assessment for survivors receiving allogeneic hematopoietic stem cell transplantation.

机构信息

Department of Hematology and Oncology, Ulsan University Hospital, University of Ulsan College of Medicine, 877, Bangeojinsunhwandoro, Dong-gu, Ulsan, 44033, South Korea.

Department of Psychiatry, Ulsan University Hospital, University of Ulsan College of Medicine, 877, Bangeojinsunhwandoro, Dong-gu, Ulsan, 44033, South Korea.

出版信息

Support Care Cancer. 2021 Feb;29(2):975-986. doi: 10.1007/s00520-020-05572-0. Epub 2020 Jun 17.

Abstract

PURPOSE

The survival rates of patients undergoing allogeneic hematopoietic stem cell transplantation (HSCT) have improved. However, HSCT can induce significant long-term complications. Therefore, we investigated the late complications and risk factors for quality of life (QOL) post-HSCT.

METHODS

We retrospectively analyzed 67 adult survivors over 2 years after HSCT between 2015 and 2018 at Ulsan University Hospital, Ulsan, Korea. The survey data including FACT-BMT, Hospital Anxiety and Depression Scale, and NCCN Distress Thermometer were collected as patient-reported outcomes using a tablet PC during a routine practice of survivorship clinic.

RESULTS

The median age was 46 years. The most common symptom was fatigue (80.6%). Younger age (< 60 years), acute lymphoblastic leukemia (ALL), chronic graft-versus-host disease (GVHD), and immunosuppressant use were significantly associated with worse QOL and depression. Additionally, younger survivors (< 60 years) showed significantly more fatigue and anxiety compared with elderly survivors (≥ 60 years). Female sex was significantly associated with lower physical well-being and higher distress than male sex.

CONCLUSION

Younger patients (< 60 years), female, ALL, chronic GVHD, and continuous immunosuppressant use were significant risk factors for worse QOL and depression. Hence, creating a more active survivorship care plan after HSCT, specifically for these patients, is required.

摘要

目的

异体造血干细胞移植(HSCT)患者的生存率有所提高。然而,HSCT 可引起显著的长期并发症。因此,我们研究了 HSCT 后患者的晚期并发症和生活质量(QOL)的危险因素。

方法

我们回顾性分析了 2015 年至 2018 年在韩国蔚山大学医院接受 HSCT 且随访时间超过 2 年的 67 例成年幸存者。使用平板电脑在生存随访门诊的常规实践中收集了包括 FACT-BMT、医院焦虑和抑郁量表以及 NCCN 痛苦温度计在内的调查数据,作为患者报告的结果。

结果

中位年龄为 46 岁。最常见的症状是疲劳(80.6%)。年龄较小(<60 岁)、急性淋巴细胞白血病(ALL)、慢性移植物抗宿主病(GVHD)和免疫抑制剂的使用与较差的 QOL 和抑郁显著相关。此外,年轻幸存者(<60 岁)的疲劳和焦虑程度明显高于老年幸存者(≥60 岁)。与男性相比,女性的身体状况明显较差,痛苦程度明显较高。

结论

年龄较小(<60 岁)、女性、ALL、慢性 GVHD 和持续使用免疫抑制剂是 QOL 较差和抑郁的显著危险因素。因此,HSCT 后需要为这些患者制定更积极的生存随访计划。

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