Autologous stem cell transplantation (ASCT) is typically a 3-phase experience for patients with multiple myeloma or relapsed or refractory lymphoma. Patients often report symptoms and effects on their quality of life (QOL) as a result of disease or the complex treatment. But research on symptoms and health-related quality of life (HRQOL) in the pre- and posttransplantation phases of treatment, which typically occur in the outpatient setting, are lacking.
A team of researchers set out to learn more. They conducted a longitudinal observational study with 47 participants at a Swiss tertiary care hospital to assess symptoms, HRQOL, and associations between symptoms and HRQOL in people undergoing ASCT for lymphoma or myeloma. Their results were published in the European Journal of Oncology Nursing.
The researchers found symptoms varied throughout the process, increasing after ASCT and decreasing during the posttransplantation phase. They found the number of symptoms reported by patients in the pretransplantation phase “considerable,” noting that more than half the participants reported 6 or more symptoms. The highest number of symptoms was reported at the first assessment after transplantation. The most common symptoms were lack of energy, numbness or tingling in the hands or feet, and pain.
However, the researchers noted that while the patients reported that their symptoms did decrease during the third phase, symptoms still lingered or affected many of them 3 months after discharge.
“The knowledge about the most prevalent symptoms provides a basis for identifying options for interventions and for better educating patients and caregivers about what to expect prior to and after ASCT in the outpatient setting,” the researchers wrote, adding that this should include “realistic information about the duration of symptom persistence” to better prepare them for what to expect.
Because patients will need to be prepared to cope with any symptoms that develop after they are discharged from the hospital, healthcare professionals will need to provide them with contact information and let them know that support is available.
Study limitations included the fact that it was a single-center study in which the design depended on local symptom management strategies, as well as a small sample size that did not allow for subgroup analysis. The researchers also noted when a patient’s condition deteriorated enough to prevent them from participating that might have led to underestimation of symptom prevalence and overestimation of quality of life scores.
Stamm SL, Spichiger E, Pabst T, Pabst T, Bachnick S, Jeitziner MM. Symptom prevalence and health-related quality of life in patients undergoing autologous stem cell transplantation – a longitudinal observational study. Eu J Oncol Nurs. Published online June 25, 2021. doi:10.1016/j.ejon.2021.101997