• Cancer · Mar 2015

    Quality of life and mood of patients and family caregivers during hospitalization for hematopoietic stem cell transplantation.

    • Areej R El-Jawahri, Lara N Traeger, Kailyn Kuzmuk, Justin R Eusebio, Harry B Vandusen, Jennifer A Shin, Tanya Keenan, Emily R Gallagher, Joseph A Greer, William F Pirl, Vicki A Jackson, Karen K Ballen, Thomas R Spitzer, Timothy A Graubert, Steven L McAfee, Bimalangshu R Dey, Yi-Bin A Chen, and Jennifer S Temel.
    • Department of Hematology Oncology, Massachusetts General Hospital, Boston, MA.
    • Cancer. 2015 Mar 15; 121 (6): 951-9.

    BackgroundWe conducted a study to investigate the impact of hospitalization for hematopoietic stem cell transplantation (HCT) on the quality of life (QOL) and mood of patients and family caregivers (FC).MethodsWe conducted a longitudinal study of patients who were hospitalized for HCT and their FC. We assessed QOL (using the Functional Assessment of Cancer Therapy-Bone Marrow Transplantation) and mood (using the Hospital Anxiety and Depression Scale) at baseline (6 days before HCT), day +1, and day +8 of HCT. We administered the Medical Outcomes Study Health Survey Short Form-36 to examine FC QOL (Physical Component Scale and Mental Component Scale). To identify predictors of changes in QOL, we used multivariable linear mixed models.ResultsWe enrolled 97% of eligible patients undergoing autologous (30 patients), myeloablative (30 patients), or reduced intensity (30 patients) allogeneic HCT. Patients' QOL markedly declined (mean Functional Assessment of Cancer Therapy-Bone Marrow Transplantation score, 109.6 to 96.0; P<.0001) throughout hospitalization. The percentage of patients with depression (Hospital Anxiety and Depression Scale-Depression score of >7) more than doubled from baseline to day +8 (15.6% to 37.8%; P<.0001), whereas the percentage of patients with anxiety remained stable (22.2%; P = .8). These results remained consistent when data were stratified by HCT type. Baseline depression (β, -2.24; F, 42.2 [P<.0001]) and anxiety (β, -0.63; F, 4.4 [P =.03]) were found to independently predict worse QOL throughout hospitalization. FC QOL declined during the patient's hospitalization (physical component scale: 83.1 to 79.6 [P =.03] and mental component scale: 71.6 to 67.4 [P =.04]).ConclusionsPatients undergoing HCT reported a steep deterioration in QOL and substantially worsening depression during hospitalization. Baseline anxiety and depression predicted worse QOL during hospitalization, underscoring the importance of assessing pre-HCT psychiatric morbidity.© 2014 American Cancer Society.

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