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 Blood, 2 July 2009, Vol. 114, No. 1, pp. 7-19.
Prepublished online as a Blood First Edition Paper on March 31, 2009; DOI 10.1182/blood-2008-10-182592.

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REVIEW ARTICLE

Quality of life after allogeneic hematopoietic cell transplantation

Joseph Pidala1,2, Claudio Anasetti1,2, and Heather Jim2,3

1 Department of Blood and Marrow Transplantation, Moffitt Cancer Center, Tampa, FL; 2 Oncologic Sciences, University of South Florida, Tampa; and 3 Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL

High-dose therapy with allogeneic hematopoietic cell transplantation (HCT) offers effective control and potential cure of hematopoietic malignancies, but with the cost of associated morbidity that includes adverse effects on quality of life (QOL). A growing body of literature has characterized this impact. Longitudinal studies suggest early moderate impairments that largely return to pretransplantation levels by day 100; the majority of studies suggest that greater than 60% of patients report good to excellent QOL in years 1 to 4 after HCT. Comparisons of allogeneic HCT with autologous HCT and standard-dose chemotherapy suggest impairments in QOL and a different trajectory of recovery in allogeneic HCT, but these conclusions are limited by confounding variables. Cross-sectional studies suggest larger and more persistent decrements in QOL in comparison with matched noncancer controls and population normative data. Acute and chronic graft-versus-host disease (GVHD) are significant threats to QOL. Behavioral interventions show promise to maintain or improve quality of life after allogeneic HCT. The review concludes with recommendations to investigators and clinicians as the state of this research advances.


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