Bone Marrow Transplantation Complications Impact Cancer Survivor or Quality of Life

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Long-term cancer survivors report that health complications arising after their bone marrow transplants had the most impact on their physical well-being but did not affect their psychological or spiritual well-being, according to an epidemiological study by Smita Bhatia, M.D., M.P.H., director, Division of Population Sciences, City of Hope.

There have been studies that identified complications from HCT, and other studies that described patient quality of life, but this is the first that examines the impact of complications on quality of life, which can help us better understand the needs of cancer survivors

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Long-term cancer survivors report that health complications arising after their bone marrow transplants had the most impact on their physical well-being but did not affect their psychological or spiritual well-being, according to an epidemiological study by Smita Bhatia, M.D., M.P.H., director, Division of Population Sciences, City of Hope. Data from the first-ever study of adult survivors of hematopoietic cell transplantation (HCT) that examined the impact of long-term complications on their quality of life was presented at the 48th Annual American Society of Hematology (ASH) Annual Meeting in Orlando, Fla.

More than 45,000 HCT procedures are conducted annually to treat a variety of life-threatening diseases, such as leukemia and lupus. There are currently more than 100,000 transplant survivors who have surpassed a 5-year survival milestone. However, due to their HCT treatment, which includes chemotherapy, radiation and immunosuppressive drugs, they are at increased risk of developing a wide-range of complications that could potentially have an impact on their lives.

"The goal of the study was to examine the impact of long-term health complications on the quality of life in long-term transplant survivors. The surveys revealed that not all health complications are equal and only some, not all, complications have a negative impact on survivors' overall quality of life," said Bhatia. "Many cancer survivors believe that their lives will return to normal after treatment. So, it is the problems that they encounter during their daily routines that they see as truly impacting their quality of life."

Researchers collected surveys from 1,013 cancer survivors who underwent HCT procedures at City of Hope or the University of Minnesota. The study examined their long-term complications and assessed their health-related quality of life, which was broken out into physical, psychological, social, and spiritual well-being, and overall quality of life categories. Researchers focused on complications such as impaired hearing, vision problems, speech difficulties, dental problems, cardiac dysfunction, stroke, hip joint replacement, pulmonary problems, gastrointestinal distress and neurologic conditions. Adjustments were made for certain factors, including inability to return to work, pain or anxiety, marital status, age and gender.

Patients reported that physical well-being was most affected by complications that caused hearing, speech, dental, cardiopulmonary, gastrointestinal and neurological problems. Similarly, survivors rated speech, dental, gastrointestinal and neurologic problems as the most detrimental to their social well-being. While individual patient response varied, on the whole, complications had no statistical significance in psychological well-being, and stroke was the only complication that impacted spiritual well-being.

"There have been studies that identified complications from HCT, and other studies that described patient quality of life, but this is the first that examines the impact of complications on quality of life, which can help us better understand the needs of cancer survivors," said Bhatia. "Data from this study raises awareness of the impact of treatment-related complications and suggests areas to investigate during follow-up care. The data should help us develop appropriate interventions for HCT patients to enable a better quality of life after cancer treatment."

Bhatia will continue her research into cancer survivorship with studies that will compare quality of life scores before, during and after HCT procedures to understand what is most important to patient care at the different stages of their cancer treatment.

About City of Hope

City of Hope is a leading research and treatment center for cancer, diabetes and other life-threatening diseases. Designated as a Comprehensive Cancer Center, the highest honor bestowed by the National Cancer Institute, and a founding member of the National Comprehensive Cancer Network, City of Hope's research and treatment protocols impact care throughout the nation. Founded in 1913, City of Hope is a pioneer in the fields of bone marrow transplantation and genetics and shares its scientific knowledge with medical centers locally and globally, helping patients battling serious diseases. For more information, visit http://www.cityofhope.org.

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