Quality of life and mood of patients and family caregivers during hospitalization for hematopoietic stem cell transplantation
Open accessAbstract
BACKGROUND: We conducted a study to investigate the impact of hospitalization for hematopoietic stem cell transplantation (HCT) on the quality of life (QOL) and mood of patients and family caregivers (FC). METHODS: We conducted a longitudinal study of patients who were hospitalized for HCT and their FC. We assessed QOL (using the Functional Assessment of Cancer Therapy‐Bone Marrow Transplantation) and mood (using the Hospital Anxiety and Depression Scale) at baseline (6 days before HCT), day +1, and day +8 of HCT. We administered the Medical Outcomes Study Health Survey Short Form‐36 to examine FC QOL (Physical Component Scale and Mental Component Scale). To identify predictors of changes in QOL, we used multivariable linear mixed models. RESULTS: We enrolled 97% of eligible patients undergoing autologous (30 patients), myeloablative (30 patients), or reduced intensity (30 patients) allogeneic HCT. Patients' QOL markedly declined (mean Functional Assessment of Cancer Therapy‐Bone Marrow Transplantation score, 109.6 to 96.0; P<.0001) throughout hospitalization. The percentage of patients with depression (Hospital Anxiety and Depression Scale‐Depression score of >7) more than doubled from baseline to day +8 (15.6% to 37.8%; P<.0001), whereas the percentage of patients with anxiety remained stable (22.2%; P = .8). These results remained consistent when data were stratified by HCT type. Baseline depression (β, −2.24; F, 42.2 [P<.0001]) and anxiety (β, −0.63; F, 4.4 [P =.03]) were found to independently predict worse QOL throughout hospitalization. FC QOL declined during the patient's hospitalization (physical component scale: 83.1 to 79.6 [P =.03] and mental component scale: 71.6 to 67.4 [P =.04]). CONCLUSIONS: Patients undergoing HCT reported a steep deterioration in QOL and substantially worsening depression during hospitalization. Baseline anxiety and depression predicted worse QOL during hospitalization, underscoring the importance of assessing pre‐HCT psychiatric morbidity. Cancer 2015;121:951–959. © 2014 American Cancer Society.
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Cancer increases risk for psychological distress, which is linked with poorer quality of life, greater barriers to quality cancer care, and worse morbidity and mortality.
“These coping patterns are important because cancer elevates risk for psychological distress (25) which in turn has been linked with poorer QOL (26–28), greater barriers to quality cancer care (29–33) and worse morbidity and mortality (32–36).”
From Coping in Patients With Incurable Lung and Gastrointestinal Cancers: A Validation Study of the Brief COPE (2017) · cites this paper as [26]
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References 26 · Cited by 218
- Authors
- El‐Jawahri, A. R., Traeger, L. N., Kuzmuk, K., Eusebio, J. R., Vandusen, H. B., Shin, J. A., Keenan, T., Gallagher, E. R., Greer, J. A., Pirl, W. F., Jackson, V. A., Ballen, K. K., Spitzer, T. R., Graubert, T. A., McAfee, S. L., Dey, B. R., Chen, Y. A., & Temel, J. S.
- Affiliations
- Department of Hematology Oncology Massachusetts General Hospital Boston MA
- Massachusetts General Hospital (US)
- ORCID
- Venue
- Cancer
- Publisher
- Wiley
- Published
- 2014-12-02
- Volume
- 121
- Issue
- 6
- Pages
- 951-959
- ISSN
- 0008-543X (ISSN-L)
- 1097-0142
- PMC
- PMC4352120
- OpenAlex
- W1567421824
- Cited by
- 218
- References
- 26
- Citations by year
- 2026: 7 · 2025: 18 · 2024: 25 · 2023: 25 · 2022: 17 · 2021: 23 · 2020: 26 · 2019: 22 · 2018: 22 · 2017: 11 · 2016: 13 · 2015: 8
- FWCI
- 5.14
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Cancer (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Cancer Institute (K24CA181253)
- Topics
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Health Sciences › Medicine › Hematology › Hematopoietic Stem Cell Transplantation
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Cancer-related cognitive impairment studies
- Keywords
- hematopoietic stem cell transplantation, quality of life, mood, depression, anxiety, family caregivers, caregiver quality of life, hospitalization, allogeneic transplantation, autologous transplantation, reduced-intensity conditioning
- MeSH terms
- Affect, Female, Hospitalization, Humans, Longitudinal Studies, Male, Middle Aged, Prospective Studies, Quality of Life, Caregivers, Hematopoietic Stem Cell Transplantation, Transplantation Conditioning
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