Hematopoietic-cell transplantation (bone-marrow transplant or stem-cells transplant) is an effective and widely used treatment for hematologic (blood) malignancies. Yet, the rate and predictors of physical and emotional recovery after HCT have not been adequately defined in long-term studies. Improved understanding of recovery could facilitate more accurate informed consent, permit better planning by patients, families, and medical teams, and enable the design of interventions to improve functional recovery.
Dr. Karen L. Syrjala, head of biobehavorial sciences at Fred Hutchinson Cancer Research Center in Seattle, and colleagues conducted a study to examine recovery of physical and mental health and return to work after HCT for treatment of leukemia or lymphoma. Patient function was assessed from pretransplantation to 5-year follow-up for 319 adults who had myeloablative (bone-marrow suppression) HCT for treatment of leukemia or lymphoma. Of the 99 long-term survivors who had no recurrent malignancy, 94 completed 5-year follow-up.
"The impetus for doing this study came from patients telling us that they wanted to know more about what life was like for people after transplant and our own interest in understanding which patients had difficulties in the long term and who did better," said Syrjala. "Now we can take what we learned and help people who are more likely to have a difficult time during recovery. We want everyone to have the best chance for a full life after treatment."
The researchers found that physical recovery occurred earlier than psychological or work recovery. Only 19 percent of patients recovered on all outcomes at 1 year. The proportion without major limitations increased to 63 per
Contact: Susan Edmonds
Fred Hutchinson Cancer Research Center