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Blood, 1 February 2008, Vol. 111, No. 3, pp. 1740-1741. This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Rovó, A. Articles by Tichelli, A. Search for Related Content PubMed PubMed Citation Articles by Rovó, A. Articles by Tichelli, A. Related Collections Related Article in Blood Online Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  CORRESPONDENCE Physical and not mental health is impaired in very long-term survivors after HSCT compared with their respective donors: a paired analysis To the editor: Bhatia and colleagues1 recently published a comprehensive analysis on late mortality after allogeneic hematopoietic stem cell transplantation (HSCT), providing interesting data about the functional status of 547 recipients and 319 siblings. At the time of this Collaborative Bone Marrow Transplant Survivor Study, patients and donors had a median age of 41.5 and 44 years, respectively, and a median time of 8.6 years after HSCT. By questionnaire, long-term survivors reported significantly more difficulties in integration back into society after HSCT, in holding down employment, or in obtaining or retaining health insurance compared with their siblings. These results provided additional information to the relatively scarce and partially conflicting reports on functional status in the long-term recipients of HSCT surviving more than 10 years.2,3 In order to obtain a comprehensive overview on physical and mental health in very long-term survivors after HSCT, we invited 44 recipients and their respective HLA-identical sibling donors to take part in a prospective study at the University Hospital of Basel. Both the recipients and their donors were controlled at the same time point, in pairs, and were given a complete clinical and biologic examination. Each answered a Short Form 36 (SF-36) Health Survey,4,5 which provides the generic health status measure using 36 items assessing 8 different concepts (Table 1). Three of the concepts provide a score for physical health, 3 for mental health, and 2 for general health status. These 8 concepts are summarized in 2 global tests, one for physical and one for mental health. Norm-based scores were used, in which 50 represents the mean score, and 10 the standard deviation for the general population. The median age of the recipients and donors at time of the study was 44.3 years (24-63) and 43.4 years (22-61), respectively, with a median time of 17.5 years (range, 11-26 years) after HSCT. Four patients received an HSCT for aplastic anemia and 40 for hematologic malignancies. All patients received bone marrow as stem cell source and total body irradiation was part of the conditioning in 39 patients (89%). Acute graft-versus-host disease (GVHD) was observed in 31 (70%), and chronic GVHD in 22 (50%) patients. View this table: [in this window] [in a new window]   Table 1. Short Form 36 Health Survey: Paired comparison between recipients and their respective donor   In a paired comparison, recipients showed a significantly lower rank of the norm-based scores for all questions related to physical well-being, except for role limitation, but no difference in the mental health scores compared with their respective donors (Table 1). This is confirmed by the global test for physical (P = .001) and mental (P = .831) health. Physical health was significantly lower in patients with extensive chronic GVHD (P = .05), in females (P = .024), in recipients older than 25 years at HSCT (P = .024) or older than 42 years at study evaluation (P = .05). None of these factors had an impact on mental heath status (MCS, P > .10). In summary, our data extend the findings reported by Bhatia et al1 on the functional health status in long-term survivors, validating the finding that the physical health status of very long-term survivors after HSCT can be impaired, while mental health status remains preserved. Authorship This study was supported by the Horton Foundation and by the Swiss National Research Foundation grant 3200130-1181176. Conflict-of-interest disclosure: The authors declare no competing financial interests. Correspondence: Alicia Rovó, Department of Hematology, Petersgraben 4, University Hospital of Basel, Basel 4031, Switzerland; e-mail: arovo{at}uhbs.ch. Alicia Rovó, Thomas Daikeler, Martin Stern, Jörg Halter, Jan Dirk Studt, Andreas Buser, Dominik Heim, Johannes Rischewski, Michael Medinger, Alan Tyndall, Alois Gratwohl, and André Tichelli References Bhatia S, Francisco L, Carter A, et al. Late mortality after allogeneic hematopoietic cell transplantation and functional status of long-term survivors: report from the Bone Marrow Transplant Survivor Study. Blood 2007; 110:3784–3792.[Abstract/Free Full Text] Duell T, van Lint MT, Ljungman P, et al. Health and functional status of long-term survivors of bone marrow transplantation. EBMT Working Party on Late Effects and EULEP Study Group on Late Effects, European Group for Blood and Marrow Transplantation. Ann Intern Med 1997; 126:184–192.[Abstract/Free Full Text] Wingard JR, Curbow B, Baker F, Piantadosi S. Health, functional status, and employment of adult survivors of bone marrow transplantation. Ann Intern Med 1991; 114:113–118.[CrossRef][Medline] [Order article via Infotrieve] Ware JE Jr and Shebourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 1992; 30:473–483.[Medline] [Order article via Infotrieve] McHorney CA, Ware JE Jr, Raczek AE. The MOS 36-item Short-Form Health Survey (SF-36): II. Psychometric and clinical tests of validity in measuring physical and mental health constructs. Med Care 1993; 31:247–263.[Medline] [Order article via Infotrieve] CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? Related Article in Blood Online: Late mortality after allogeneic hematopoietic cell transplantation and functional status of long-term survivors: report from the Bone Marrow Transplant Survivor Study Smita Bhatia, Liton Francisco, Andrea Carter, Can-Lan Sun, K. Scott Baker, James G. Gurney, Philip B. McGlave, Auayporn Nademanee, Margaret O'Donnell, Norma K. C. Ramsay, Leslie L. Robison, David Snyder, Anthony Stein, Stephen J. Forman, and Daniel J. Weisdorf Blood 2007 110: 3784-3792. [Abstract] [Full Text] [PDF] This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Rovó, A. Articles by Tichelli, A. Search for Related Content PubMed PubMed Citation Articles by Rovó, A. Articles by Tichelli, A. Related Collections Related Article in Blood Online Social Bookmarking                   What's this?

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