Adolescent and young adult (AYA) cancer survivors who undergo hematopoietic stem cell transplantation (HSCT) may not have a higher incidence of posttraumatic stress symptoms (PTSS) compared with their healthy peers, but may experience differences in health-related quality of life (HRQOL), according to a study published in the European Journal of Cancer Care.
HSCT is becoming a primary form of therapy for pediatric patients with cancer. While the impact of HSCT on medical and physical outcomes are well understood, there is a paucity of data in regards to its effect on HRQOL and psychological symptoms of survivors.
For this study, researchers enrolled 32 AYA HSCT childhood survivors and matched them with 28 healthy peers. Sociodemographic and medical information were assessed at baseline using self-reported questionnaires such as the short-form health survey (SF-36), ladder of life, and PTSD scale. The median age was 19.4 years.
Results showed that the majority of patients — nearly 80% of survivors — did not exhibit signs or symptoms of PTSS; 12.5% had subclinical presence of PTSS, and 9.4% had a clinical profile of PTSS. Intrusion symptoms were most commonly reported among those who underwent autologous HSCT, and patients who experienced relapse in treatment were associated with more PTSS avoidance symptoms.
Women reported poorer outcomes on the SF-36 scale compared with men. Nearly 90% of survivors were in the lowest quartile of the SF-36 general well-being scale, and 70.8% reported having similarly poor statuses on the SF-36 fatigue scale.
Survivors reported having a lower perception of life satisfaction when thinking of their past, but had better emotional well-being and felt as though they had fewer limitations compared with their healthy peers.
The authors added that various interventions, such as physical rehabilitation and psychological support programs, could improve the quality of life and outcomes among these vulnerable patients after HSCT.
Tremolada M, Bonichini S, Taverna L, Basso G, Pillon M. Health-related quality of life in AYA cancer survivors who underwent HSCT compared with healthy peers [published online July 31, 2018]. Eur J Cancer Care. doi: 10.1111/ecc.12878