Submitted October 7, 2008
Accepted March 24, 2009
Quality of life after allogeneic hematopoietic cell transplantation
Joseph Pidala, Claudio Anasetti, and Heather Jim*
Department of Blood and Marrow Transplantation, Moffitt Cancer Center, Tampa, FL, United States
Department of Oncologic Sciences, University of South Florida, Tampa, FL, United States
Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, United States
* Corresponding author; email: heather.jim{at}moffitt.org.
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 pre-transplant levels by day 100; the majority of studies suggest that greater than 60% of patients report good to excellent QOL in years 1-4 after HCT. Comparisons of allogeneic HCT to autologous HCT and standard-dose chemotherapy suggest impairments in QOL and 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 to matched non-cancer controls and population normative data. Acute and chronic graft vs. host disease (GVHD) are significant threats to QOL. Behavioral interventions show promise to maintain or improve quality of life following allogeneic HCT. The review concludes with recommendations to investigators and clinicians as the state of this research advances.
