Late complications and quality of life assessment for survivors receiving allogeneic hematopoietic stem cell transplantation

Abstract

Purpose: 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. Methods: 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. Results: 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. Conclusion: 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.