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Quality of life concerns and depression among hematopoietic stem cell transplant survivors

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Abstract

Purpose

This study examined quality of life, transplant-related concerns, and depressive symptoms and their demographic and medical correlates at 1 to 3 years following hematopoietic stem cell transplantation (HSCT).

Methods

HSCT survivors (N = 406) completed telephone-administered questionnaires that assessed demographic variables, functional status, quality of life, transplant-related concerns, and depressive symptoms.

Results

The most prevalent concerns among HSCT survivors included physical symptoms (e.g., fatigue and pain), maintaining current health status and employment, changes in appearance, and lack of sexual interest and satisfaction. In addition, almost one-third (32%) of survivors age 40 years and younger reported concern about their ability to have children. Unemployed survivors and those with lower incomes and worse functional status were more likely to experience poorer quality of life in multiple domains. Fifteen percent of the sample reported moderate to severe depressive symptoms, and these symptoms were higher among allogeneic transplant recipients and those with lower functional status.

Conclusions

Results suggest that interventions are needed to address physical symptoms, coping with an uncertain future, infertility, and sexual issues during the early phase of HSCT survivorship.

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References

  1. Andorsky DJ, Loberiza FR, Lee SJ (2006) Pre-transplantation physical and mental functioning is strongly associated with self-reported recovery from stem cell transplantation. Bone Marrow Transplant 37:889–895

    Article  PubMed  CAS  Google Scholar 

  2. Andrykowski MA, Cordova MJ, Hann DM, Jacobsen PB, Fields KK, Phillips G (1999) Patients’ psychosocial concerns following stem cell transplantation. Bone Marrow Transplant 24:1121–1129

    Article  PubMed  CAS  Google Scholar 

  3. Baker F, Denniston M, Zabora JR, Marcellus D (2003) Cancer problems in living and quality of life after bone marrow transplantation. J Clin Psychol Med Settings 10:27–34

    Article  Google Scholar 

  4. Beck AT (1988) Psychometric properties of the Beck Depression Inventory: twenty-five years of evaluation. Clin Psychol Rev 8:77–100

    Article  Google Scholar 

  5. Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J (1961) An inventory for measuring depression. Arch Gen Psychiatry 4:561–571

    PubMed  CAS  Google Scholar 

  6. Bieri S, Roosnek E, Helg C, Verholen F, Robert D, Chapuis B, Passweg J, Miralbell R, Chalandon Y (2008) Quality of life and social integration after allogeneic hematopoietic SCT. Bone Marrow Transplant 42:819–827

    Article  PubMed  CAS  Google Scholar 

  7. Bishop MM, Beaumont JL, Hahn EA, Cella D, Andrykowski MA, Brady MJ, Horowitz MM, Sobocinski KA, Rizzo JD, Wingard JR (2007) Late effects of cancer and hematopoietic stem-cell transplantation on spouses or partners compared with survivors and survivor-matched controls. J Clin Oncol 25:1403–1411

    Article  PubMed  Google Scholar 

  8. Broers S, Kaptein AA, Le Cessie S, Fibbe W, Hengeveld MW (2000) Psychological functioning and quality of life following bone marrow transplantation: a 3-year follow-up study. J Psychosom Res 48:11–21

    Article  PubMed  CAS  Google Scholar 

  9. Cella DF, Tulsky DS, Gray G, Sarafian B, Linn E, Bonomi A, Silberman M, Yellen SB, Winicour P, Brannon J et al (1993) The Functional Assessment of Cancer Therapy scale: development and validation of the general measure. J Clin Oncol 11:570–579

    PubMed  CAS  Google Scholar 

  10. Chang G, Orav EJ, McNamara TK, Tong MY, Antin JH (2005) Psychosocial function after hematopoietic stem cell transplantation. Psychosomatics 46:34–40

    Article  PubMed  Google Scholar 

  11. Chatterjee R, Kottaridis PD (2002) Treatment of gonadal damage in recipients of allogeneic or autologous transplantation for haematological malignancies. Bone Marrow Transplant 30:629–635

    Article  PubMed  CAS  Google Scholar 

  12. Conner-Spady BL, Cumming C, Nabholtz JM, Jacobs P, Stewart D (2005) A longitudinal prospective study of health-related quality of life in breast cancer patients following high-dose chemotherapy with autologous blood stem cell transplantation. Bone Marrow Transplant 36:251–259

    Article  PubMed  CAS  Google Scholar 

  13. Copelan EA (2006) Hematopoietic stem-cell transplantation. N Engl J Med 354:1813–1826

    Article  PubMed  CAS  Google Scholar 

  14. Costanzo ES, Ryff CD, Singer BH (2009) Psychosocial adjustment among cancer survivors: findings from a national survey of health and well-being. Health Psychol 28:147–156

    Article  PubMed  Google Scholar 

  15. Gielissen MF, Schattenberg AV, Verhagen CA, Rinkes MJ, Bremmers ME, Bleijenberg G (2007) Experience of severe fatigue in long-term survivors of stem cell transplantation. Bone Marrow Transplant 39:595–603

    Article  PubMed  CAS  Google Scholar 

  16. Gulati SC, Van Poznak C (1998) Pregnancy after bone marrow transplantation. J Clin Oncol 16:1978–1985

    PubMed  CAS  Google Scholar 

  17. Hammond C, Abrams JR, Syrjala KL (2007) Fertility and risk factors for elevated infertility concern in 10-year hematopoietic cell transplant survivors and case-matched controls. J Clin Oncol 25:3511–3517

    Article  PubMed  Google Scholar 

  18. Hann DM, Jacobsen PB, Martin SC, Kronish LE, Azzarello LM, Fields KK (1997) Quality of life following bone marrow transplantation for breast cancer: a comparative study. Bone Marrow Transplant 19:257–264

    Article  PubMed  CAS  Google Scholar 

  19. Heinonen H, Volin L, Uutela A, Zevon M, Barrick C, Ruutu T (2001) Gender-associated differences in the quality of life after allogeneic BMT. Bone Marrow Transplant 28:503–509

    Article  PubMed  CAS  Google Scholar 

  20. Hjermstad MJ, Knobel H, Brinch L, Fayers PM, Loge JH, Holte H, Kaasa S (2004) A prospective study of health-related quality of life, fatigue, anxiety and depression 3–5 years after stem cell transplantation. Bone Marrow Transplant 34:257–266

    Article  PubMed  CAS  Google Scholar 

  21. Humphreys CT, Tallman B, Altmaier EM, Barnette V (2007) Sexual functioning in patients undergoing bone marrow transplantation: a longitudinal study. Bone Marrow Transplant 39:491–496

    Article  PubMed  CAS  Google Scholar 

  22. Jenks Kettmann JD, Altmaier EM (2008) Social support and depression among bone marrow transplant patients. J Health Psychol 13:39–46

    Article  PubMed  Google Scholar 

  23. Karnofsky DA, Abelmann WH, Graver LF, Buekenal JH (1948) The use of nitrogen mustards in the palliative treatment of cancer. Cancer 1:634–656

    Article  Google Scholar 

  24. Kiss TL, Abdolell M, Jamal N, Minden MD, Lipton JH, Messner HA (2002) Long-term medical outcomes and quality-of-life assessment of patients with chronic myeloid leukemia followed at least 10 years after allogeneic bone marrow transplantation. J Clin Oncol 20:2334–2343

    Article  PubMed  CAS  Google Scholar 

  25. Kopp M, Schweigkofler H, Holzner B, Nachbaur D, Niederwieser D, Fleischhacker WW, Sperner-Unterweger B (1998) Time after bone marrow transplantation as an important variable for quality of life: results of a cross-sectional investigation using two different instruments for quality-of-life assessment. Ann Hematol 77:27–32

    Article  PubMed  CAS  Google Scholar 

  26. Lee SJ, Fairclough D, Parsons SK, Soiffer RJ, Fisher DC, Schlossman RL, Antin JH, Weeks JC (2001) Recovery after stem-cell transplantation for hematologic diseases. J Clin Oncol 19:242–252

    PubMed  CAS  Google Scholar 

  27. Lee SJ, Kim HT, Ho VT, Cutler C, Alyea EP, Soiffer RJ, Antin JH (2006) Quality of life associated with acute and chronic graft-versus-host disease. Bone Marrow Transplant 38:305–310

    Article  PubMed  CAS  Google Scholar 

  28. Lee SJ, Loberiza FR, Antin JH, Kirkpatrick T, Prokop L, Alyea EP, Cutler C, Ho VT, Richardson PG, Schlossman RL, Fisher DC, Logan B, Soiffer RJ (2005) Routine screening for psychosocial distress following hematopoietic stem cell transplantation. Bone Marrow Transplant 35:77–83

    Article  PubMed  CAS  Google Scholar 

  29. Loberiza FR Jr, Lee SJ, Freytes CO, Giralt SA, Van Besien K, Kurian S, del Cerro P, Toro JJ, Williams LA, Ketelsen SW, Navarro WH, Rizzo JD (2009) Methodological and logistical considerations to study design and data collection in racial/ethnic minority populations evaluating outcome disparity in hematopoietic cell transplantation. Biol Blood Marrow Transplant 15:903–909

    Article  PubMed  Google Scholar 

  30. Loprinzi CL, Laurie JA, Wieand HS, Krook JE, Novotny PJ, Kugler JW, Bartel J, Law M, Bateman M, Klatt NE et al (1994) Prospective evaluation of prognostic variables from patient-completed questionnaires. North Central Cancer Treatment Group. J Clin Oncol 12:601–607

    PubMed  CAS  Google Scholar 

  31. Loscalzo MJ, Clark KL (2007) Problem-related distress in cancer patients drives requests for help: a prospective study. Oncology 21:1133–1138

    PubMed  Google Scholar 

  32. McQuellon RP, Russell GB, Cella DF, Craven BL, Brady M, Bonomi A, Hurd DD (1997) Quality of life measurement in bone marrow transplantation: development of the Functional Assessment of Cancer Therapy-Bone Marrow Transplant (FACT-BMT) scale. Bone Marrow Transplant 19:357–368

    Article  PubMed  CAS  Google Scholar 

  33. Mosher CE, Redd WH, Rini CM, Burkhalter JE, DuHamel KN (2009) Physical, psychological, and social sequelae following hematopoietic stem cell transplantation: a review of the literature. Psychooncology 18:113–127

    Article  PubMed  Google Scholar 

  34. Oliver JM, Simmons ME (1984) Depression as measured by the DSM-III and the Beck Depression Inventory in an unselected adult population. J Consult Clin Psychol 52:892–898

    Article  PubMed  CAS  Google Scholar 

  35. Socie G, Salooja N, Cohen A, Rovelli A, Carreras E, Locasciulli A, Korthof E, Weis J, Levy V, Tichelli A (2003) Nonmalignant late effects after allogeneic stem cell transplantation. Blood 101:3373–3385

    Article  PubMed  CAS  Google Scholar 

  36. Syrjala KL, Langer SL, Abrams JR, Storer B, Sanders JE, Flowers ME, Martin PJ (2004) Recovery and long-term function after hematopoietic cell transplantation for leukemia or lymphoma. JAMA 291:2335–2343

    Article  PubMed  CAS  Google Scholar 

  37. Syrjala KL, Langer SL, Abrams JR, Storer BE, Martin PJ (2005) Late effects of hematopoietic cell transplantation among 10-year adult survivors compared with case-matched controls. J Clin Oncol 23:6596–6606

    Article  PubMed  Google Scholar 

  38. Syrjala KL, Roth-Roemer SL, Abrams JR, Scanlan JM, Chapko MK, Visser S, Sanders JE (1998) Prevalence and predictors of sexual dysfunction in long-term survivors of marrow transplantation. J Clin Oncol 16:3148–3157

    PubMed  CAS  Google Scholar 

  39. Tierney DK (2004) Sexuality following hematopoietic cell transplantation. Clin J Oncol Nurs 8:43–47

    PubMed  Google Scholar 

  40. Wingard JR, Curbow B, Baker F, Piantadosi S (1991) Health, functional status, and employment of adult survivors of bone marrow transplantation. Ann Intern Med 114:113–118

    PubMed  CAS  Google Scholar 

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Acknowledgments

We gratefully acknowledge the contributions of Yeraz Markarian, Julian Silva, and the participating survivors. This research is supported by National Cancer Institute Grants no. R01 CA093609 (WR) and F32CA130600 (CM).

Conflict of interest

None.

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Authors and Affiliations

  1. Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, 641 Lexington Avenue, 7th Floor, New York, NY, 10022, USA

    Catherine E. Mosher, Katherine N. DuHamel, Geoffrey Corner & Joanne Lam

  2. Department of Oncological Sciences, The Mount Sinai School of Medicine, One Gustave Levy Place, Box 1130, New York, NY, 10029, USA

    Christine Rini & William H. Redd

Authors
  1. Catherine E. Mosher
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  2. Katherine N. DuHamel
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  3. Christine Rini
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  4. Geoffrey Corner
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  5. Joanne Lam
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  6. William H. Redd
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Correspondence to Catherine E. Mosher.

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Mosher, C.E., DuHamel, K.N., Rini, C. et al. Quality of life concerns and depression among hematopoietic stem cell transplant survivors. Support Care Cancer 19, 1357–1365 (2011). https://doi.org/10.1007/s00520-010-0958-y

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