This Article Full Text Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Save to my personal folders Download to citation manager Rights & Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Andrykowski, M. A. Articles by Wingard, J. R. Search for Related Content PubMed PubMed Citation Articles by Andrykowski, M. A. Articles by Wingard, J. R. Social Bookmarking                            What's this?

Long-Term Health-Related Quality of Life, Growth, and Spiritual Well-Being After Hematopoietic Stem-Cell Transplantation

From the University of Kentucky College of Medicine, Department of Medicine, Lexington, KY; University of Florida College of Medicine, Gainsville, FL; Center on Outcomes, Research and Education (CORE) at Evanston Northwestern Healthcare, Evanston, IL; Independent Consultant, Trout Creek, MI; International Bone Marrow Transplant Registry, Health Policy Institute, Medical College of Wisconsin, Milwaukee, WI

Address reprint requests to Michael A. Andrykowski, PhD, Department of Behavioral Science, University of Kentucky College of Medicine, Lexington, KY 40536-0086; e-mail: mandry{at}uky.edu

PURPOSE: To examine health-related quality of life (HRQOL) and growth, and spiritual well-being in adult survivors of hematopoietic stem-cell transplantation (HSCT) for a malignant disease.

METHODS: HSCT survivors (n = 662) were recruited through the International Bone Marrow Transplant Registry/Autologous Blood and Marrow Transplant Registry and were drawn from 40 transplantation centers. HSCT survivors completed a telephone interview and a set of questionnaires a mean of 7.0 years post-HSCT (range, 1.8 to 22.6 years). Study measures included a variety of standardized measures of HRQOL and growth and spiritual well-being. An age- and sex-matched healthy comparison (HC) group (n = 158) was recruited using a peer nomination method. The HC group completed a parallel telephone interview and set of questionnaires.

RESULTS: Multivariate analysis of variance analyses found the HSCT survivor group reported poorer status relative to the HC group for all HRQOL outcome clusters including physical health, physical functioning, social functioning, psychological adjustment, and dyadic adjustment. In contrast, the HSCT survivor group reported more psychological and interpersonal growth. Mean effect size for the 24 outcome indices examined was 0.36 standard deviations, an effect size often considered clinically meaningful or important. The largest group differences were found for measures of general health, physical function and well-being, depression, cognitive function, and fatigue.

CONCLUSION: The experience of HSCT for a malignant disease has a wide-ranging, longstanding, and profound impact on adult recipients. Relative to healthy controls, HSCT survivors reported poorer physical, psychological, and social functioning but, conversely, more psychological and interpersonal growth, differences that appeared to persist many years after HSCT.

Supported by grants R01 CA81320 (principal investigator, J.W.) and grant K23 CA82350 (principal investigator, D.R.) from the National Institutes of Health.

Authors' disclosures of potential conflicts of interest are found at the end of this article.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Facebook    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				L. B. Travis, C. Beard, J. M. Allan, A. A. Dahl, D. R. Feldman, J. Oldenburg, G. Daugaard, J. L. Kelly, M. E. Dolan, R. Hannigan, et al. Testicular Cancer Survivorship: Research Strategies and Recommendations J Natl Cancer Inst, June 28, 2010; (2010) djq216v1. [Abstract] [Full Text] [PDF]

				C. K. Ullrich, V. Dussel, J. M. Hilden, J. W. Sheaffer, L. Lehmann, and J. Wolfe End-of-life experience of children undergoing stem cell transplantation for malignancy: parent and provider perspectives and patterns of care Blood, May 13, 2010; 115(19): 3879 - 3885. [Abstract] [Full Text] [PDF]

				F. L. Wong, L. Francisco, K. Togawa, A. Bosworth, M. Gonzales, C. Hanby, M. Sabado, M. Grant, S. J. Forman, and S. Bhatia Long-term recovery after hematopoietic cell transplantation: predictors of quality-of-life concerns Blood, March 25, 2010; 115(12): 2508 - 2519. [Abstract] [Full Text] [PDF]

				J. Pidala, C. Anasetti, and H. Jim Quality of life after allogeneic hematopoietic cell transplantation Blood, July 2, 2009; 114(1): 7 - 19. [Abstract] [Full Text] [PDF]

				A. G. E. M. de Boer, T. Taskila, A. Ojajarvi, F. J. H. van Dijk, and J. H. A. M. Verbeek Cancer Survivors and Unemployment: A Meta-analysis and Meta-regression JAMA, February 18, 2009; 301(7): 753 - 762. [Abstract] [Full Text] [PDF]

				K. A. Goodman, E. Riedel, V. Serrano, S. Gulati, C. H. Moskowitz, and J. Yahalom Long-Term Effects of High-Dose Chemotherapy and Radiation for Relapsed and Refractory Hodgkin's Lymphoma J. Clin. Oncol., November 10, 2008; 26(32): 5240 - 5247. [Abstract] [Full Text] [PDF]

				K. L. Syrjala, B. F. Kurland, J. R. Abrams, J. E. Sanders, and J. R. Heiman Sexual function changes during the 5 years after high-dose treatment and hematopoietic cell transplantation for malignancy, with case-matched controls at 5 years Blood, February 1, 2008; 111(3): 989 - 996. [Abstract] [Full Text] [PDF]

				K. Mystakidou, E. Parpa, E. Tsilika, M. Pathiaki, A. Galanos, and L. Vlahos Traumatic Distress and Positive Changes in Advanced Cancer Patients American Journal of Hospice and Palliative Medicine, September 1, 2007; 24(4): 270 - 276. [Abstract] [PDF]

				M Devetten and J. Armitage Hematopoietic cell transplantation: progress and obstacles Ann. Onc., September 1, 2007; 18(9): 1450 - 1456. [Abstract] [Full Text] [PDF]

				M. M. Bishop, J. L. Beaumont, E. A. Hahn, D. Cella, M. A. Andrykowski, M. J. Brady, M. M. Horowitz, K. A. Sobocinski, J. D. Rizzo, and J. R. Wingard Late Effects of Cancer and Hematopoietic Stem-Cell Transplantation on Spouses or Partners Compared With Survivors and Survivor-Matched Controls J. Clin. Oncol., April 10, 2007; 25(11): 1403 - 1411. [Abstract] [Full Text] [PDF]

				S. M. Shankar, A. Carter, C.-L. Sun, L. Francisco, K. S. Baker, J. G. Gurney, D. G. Weisdorf, S. J. Forman, L. L. Robison, M. Grant, et al. Health Care Utilization by Adult Long-term Survivors of Hematopoietic Cell Transplant: Report from the Bone Marrow Transplant Survivor Study Cancer Epidemiol. Biomarkers Prev., April 1, 2007; 16(4): 834 - 839. [Abstract] [Full Text] [PDF]

				J. Z. Ayanian and P. B. Jacobsen Enhancing Research on Cancer Survivors J. Clin. Oncol., November 10, 2006; 24(32): 5149 - 5153. [Abstract] [Full Text] [PDF]

				C. J. Fraser, S. Bhatia, K. Ness, A. Carter, L. Francisco, M. Arora, P. Parker, S. Forman, D. Weisdorf, J. G. Gurney, et al. Impact of chronic graft-versus-host disease on the health status of hematopoietic cell transplantation survivors: a report from the Bone Marrow Transplant Survivor Study Blood, October 15, 2006; 108(8): 2867 - 2873. [Abstract] [Full Text] [PDF]

				F. Pene, C. Aubron, E. Azoulay, F. Blot, G. Thiery, B. Raynard, B. Schlemmer, G. Nitenberg, A. Buzyn, P. Arnaud, et al. Outcome of Critically Ill Allogeneic Hematopoietic Stem-Cell Transplantation Recipients: A Reappraisal of Indications for Organ Failure Supports J. Clin. Oncol., February 1, 2006; 24(4): 643 - 649. [Abstract] [Full Text] [PDF]

				K. L. Syrjala, S. L. Langer, J. R. Abrams, B. E. Storer, and P. J. Martin Late Effects of Hematopoietic Cell Transplantation Among 10-Year Adult Survivors Compared With Case-Matched Controls J. Clin. Oncol., September 20, 2005; 23(27): 6596 - 6606. [Abstract] [Full Text] [PDF]