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