1.
Health-related quality of life in patients with steroid-refractory acute graft-versus-host disease
Leeneman, B., Blommestein, H. M., van Dongen-Leunis, A., Algeri, M., Fibbe, W. E., Oosten, L., Uyl-de Groot, C. A., Thielen, F. W.
European journal of haematology. 2023
Abstract
BACKGROUND Evidence regarding health-related quality of life (HRQoL) in patients with steroid-refractory acute graft-versus-host disease (SR-aGvHD) is lacking. Evaluating HRQoL was a secondary objective of the HOVON 113 MSC trial. Here we describe the outcomes of the EQ-5D-5L, EORTC QLQ-C30, and FACT-BMT for all adult patients who completed these questionnaires at baseline (i.e., before the start of treatment; nā=ā26). METHODS Descriptive statistics were used to describe baseline patient and disease characteristics, EQ-5D dimension scores and values, EQ VAS scores, EORTC QLQ-C30 scale/item and summary scores, and FACT-BMT subscale and total scores. RESULTS The mean EQ-5D value was 0.36. In total, 96% of the patients reported problems with usual activities, 92% with pain/discomfort, 84% with mobility, 80% with self-care, and 72% with anxiety/depression. The mean EORTC QLQ-C30 summary score was 43.50. Mean scale/item scores ranged from 21.79 to 60.00 for functioning scales, from 39.74 to 75.21 for symptom scales, and from 5.33 to 91.67 for single items. The mean FACT-BMT total score was 75.31. Mean subscale scores ranged from 10.09 for physical well-being to 23.94 for social/family well-being. CONCLUSION Our study showed that HRQoL in patients with SR-aGvHD is poor. Improving HRQoL and symptom management in these patients should be a top priority.
2.
Resolved versus active chronic graft-versus-host disease: Impact on post-transplant quality of life
Kurosawa, S., Yamaguchi, T., Oshima, K., Yanagisawa, A., Fukuda, T., Kanamori, H., Mori, T., Takahashi, S., Kondo, T., Kohno, A., et al
Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation. 2019
Abstract
The aim of this study was to determine if impaired quality of life (QOL) persisted among patients who experienced resolved chronic graft-versus-host disease (GVHD) after allogeneic hematopoietic cell transplantation (allo-HCT). Eligible participants were patients who were relapse-free for 3 years after allo-HCT who were aged ≥16 years at transplant and aged ≥20 years without relapse at survey. The SF-36, FACT-BMT, and VAS were administered to assess QOL. Physicians evaluated the current status of chronic GVHD at survey by NIH criteria, and pre-transplant characteristics and history of GVHD were extracted from the national transplant registry database. Patients without currently active GVHD but with a history of chronic GVHD were categorized as having "resolved GVHD." Of 1250 patients informed of the study, 1216 provided consent, and 1130 patients were included in the final analysis. A total of 745 patients (66%) had currently active chronic GVHD, 149 (13%) had resolved chronic GVHD, and 236 (21%) never had chronic GVHD after allo-HCT. Multivariable analyses showed that compared to patients with resolved or no chronic GVHD, those with active chronic GVHD reported significantly poorer QOL. QOL scores were similar between patients with resolved and no chronic GVHD. Larger differences were observed in SF-36 physical component and VAS scores between the two groups in patients aged ≥50 years, however these were not statistically significant. In conclusion, only currently active chronic GVHD has a significant impact on physical, mental, and social QOL in allo-HCT survivors, while past chronic GVHD does not impair QOL if it is resolved.