Allogeneic hematopoietic stem cell transplantation (allo-HSCT) can leave patients with persistent and lasting effects such as impaired physical condition, decreased muscle strength, sexual problems, pain, and fatigue posttransplant. A known complication is the immune reaction chronic graft-versus-host-disease (cGVHD), which can cause tissue damage in various organs and diminish patients’ quality of life. Patients with high burden are also likely to be on long-term sick leave 1 year after transplantation.

Concerned about the lack of research into overall symptom burden on patients in the first year after allo-HSCT, a team of researchers set out to analyze patient-reported symptom burden at set time points after allo-HSCT. Their findings were published in Cancer Nursing.

The researchers enrolled 189 patients aged 18 to 65 years scheduled to undergo allo-HSCT at a hospital in Sweden. The researchers used the Symptom Frequency, Intensity and Distress Questionnaire for Stem Cell Transplantation (SFID-SCT), a 36-question tool to gauge the patients’ perceptions about their experience. Each patient was asked to complete the SFID-SCT questionnaire after admission to the allo-HSCT unit, and at 4 months, 7 months, and 1 year posttransplantation.


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“This study shows that symptom occurrence remains more consistent than symptom distress throughout the first year following an allo-HSCT and that both low physical activity and high symptom burden early in the recovery phase predict general health and sick leave 1 year after allo-HSCT,” the researchers wrote.

Specifically, the 4-month mark is a key opportunity for gauging how a patient would be faring 1 year posttransplantation. The researchers found high symptom burden and low physical activity 4 months after undergoing allo-HSCT were predictors for a patient’s poor general health and full-time sick leave at the 1-year mark.

The results of this study have implications for both patients and their healthcare providers. To decrease the burden, patients and healthcare providers need to be aware of the consequences of symptoms after allo-HSCT so they can take action earlier, according to the researchers.

“Implementing appropriate self-assessment tools could be beneficial for allo-HSCT patients, as such measures can help identify and enable strategies to reduce symptom burden, which could improve patients’ perception of health and facilitate recovery, including return to work and the transition into survivorship,” the researchers concluded.

Although the 36-item SFID-SCT questionnaire covers relevant questions related to allo-HSCT, the tool is not well validated and its use could be a study limitation.

Reference

Eriksson LV, Holmberg K, Hagelin CL, Wengstrom Y, Bergkvist K, Winterling J. Symptom burden and recovery in the first year after allogenic hematopoietic stem cell transplantation. Cancer Nursing. Published online March 11, 2022. doi:10.1097/NCC.0000000000001077