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Quality of life associated with acute and chronic graft-versus-host disease

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TLDR
The trial outcome index (TOI) of the Functional Assessment of Cancer Therapy-Bone Marrow Transplant was sensitive to occurrence of either acute or chronic GVHD, which is a major determinant of the long-term QOL of survivors.
Abstract
Acute and chronic graft-versus-host diseases (GVHD) are associated with increased morbidity and mortality after hematopoietic stem cell transplantation (HCT). We prospectively measured the quality of life (QOL) of patients undergoing allogeneic transplantation. Ninety-six subjects completed self-assessment surveys before HCT, and at 6 and/or 12 months post-HCT that included the Medical Outcomes Study Short Form 12 (SF12) and the Functional Assessment of Cancer Therapy-Bone Marrow Transplant scale. Eighty-three percent of survivors responded at 6 and 12 months. Physical and mental functioning assessed by the SF12 was not associated with either acute or chronic GVHD. In contrast, the trial outcome index (TOI) of the Functional Assessment of Cancer Therapy-Bone Marrow Transplant was sensitive to occurrence of either acute or chronic GVHD. GVHD is a major determinant of the long-term QOL of survivors. The adverse effects of acute GVHD are detectable with the TOI at 6 months post transplantation after which development of chronic GVHD is the most strongly correlated with worse QOL.

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Journal ArticleDOI

Quality of life after allogeneic hematopoietic cell transplantation

TL;DR: Comparisons of allogeneic HCT with autologous HCT and standard-dose chemotherapy suggest impairments in QOL and a different trajectory of recovery in allogenei HCT, but these conclusions are limited by confounding variables.
Journal ArticleDOI

Physical, psychological, and social sequelae following hematopoietic stem cell transplantation: a review of the literature

TL;DR: This article reviews recent literature on adults' quality of life following hematopoietic stem cell transplantation (HSCT) and concludes that there is still a need for further research into the role of prognosis and disease progression following HSCs.
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Prospective, Randomized, Double-Blind, Phase III Clinical Trial of Anti-T-Lymphocyte Globulin to Assess Impact on Chronic Graft-Versus-Host Disease-Free Survival in Patients Undergoing HLA-Matched Unrelated Myeloablative Hematopoietic Cell Transplantation.

TL;DR: A prospective, double-blind phase III trial to investigate the effect of ATLG on cGVHD-free survival found that in vivo T-cell depletion with anti-T-lymphocyte globulin reduces chronic graft-versus-host disease (cGVHD) without compromising survival.
References
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Journal ArticleDOI

A 12-Item Short-Form Health Survey: Construction of Scales and Preliminary Tests of Reliability and Validity

TL;DR: Twenty cross-sectional and longitudinal tests of empirical validity previously published for the 36-item short-form scales and summary measures were replicated for the 12-item Physical Component Summary and the12-item Mental Component Summary, including comparisons between patient groups known to differ or to change in terms of the presence and seriousness of physical and mental conditions.
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Chronic graft-versus-host disease.

TL;DR: Chronic graft versus host disease (GvHD) continues to be a significant problem in the allogeneic stem cell transplant setting and, as the authors continue to use alternative stem cell sources and attempt to modulate the immune system to increase an anti-tumour effect, they will probably see rising numbers of patients with this complication.
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Severity of chronic graft-versus-host disease: association with treatment-related mortality and relapse

TL;DR: A grading system predictive for survival was developed by using data from 1827 HLA-matched sibling allotransplant recipients reported to the International Bone Marrow Transplant Registry, and Karnofsky performance score, diarrhea, weight loss, and cutaneous and oral involvement were found to be independent prognostic variables, from which a grading scheme was generated.
Journal ArticleDOI

Quality of life measurement in bone marrow transplantation: development of the Functional Assessment of Cancer Therapy-Bone Marrow Transplant (FACT-BMT) scale

TL;DR: The 12-item bone marrow transplant subscale (BMTS) was able to discriminate patients on the basis of performance status rating and also demonstrated sensitivity to change over time, making it an excellent choice for use in BMT clinical trials.
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