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Survivorship after Autologous Hematopoietic Cell Transplantation for Lymphoma and Multiple Myeloma: Late Effects and Quality of Life.

Abstract
Although autologous hematopoietic cell transplantation (AHCT) is standard therapy for patients with lymphoma and multiple myeloma (MM), few studies have addressed late effects and quality of life (QoL) in long-term survivors after AHCT. Using long-term follow-up (LTFU) annual questionnaires with self-reported outcomes, we surveyed 665 patients who were at ≥5 years after AHCT for the diagnosis of lymphoma or MM. Three-hundred and eighty-nine patients completed the questionnaire (58% response rate) at a median of 11 years (range, 5-30 years) after AHCT. The median patient age was 63 years (range, 22-88 years) in the 268 patients with lymphoma and 69 years (range, 34-84 years) in the 121 patients with multiple myeloma. The most commonly reported medical conditions (>10% incidence) were sexual dysfunction, history of shingles, cataracts, osteoporosis or osteopenia, joint replacement, and skin cancer. Current medication use was more frequent in the patients with MM for infection prevention/treatment (19% for MM versus 5% lymphoma; P < .001), hypertension (41% versus 26%; P = .004), osteoporosis (23% versus 10%; P < .001), and pain (32% versus 11%, P < .001). Treated hypothyroidism was more common in lymphoma patients. In multivariate analysis combining lymphoma and MM, worse physical functioning was associated with older age, shorter interval since AHCT, comorbidities, relapse, and treatment for depression and/or pain. Worse mental functioning was associated with younger age and treatment for anxiety, depression, or pain. In conclusion, AHCT survivors report generally good QoL but many late effects and symptoms that are potentially amenable to intervention.
AuthorsGeorge E Georges, Merav Bar, Lynn Onstad, Jean C Yi, Mazyar Shadman, Mary E Flowers, Paul A Carpenter, Susan Stewart, Stephanie J Lee, Leona A Holmberg
JournalBiology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation (Biol Blood Marrow Transplant) Vol. 26 Issue 2 Pg. 407-412 (02 2020) ISSN: 1523-6536 [Electronic] United States
PMID31605822 (Publication Type: Journal Article, Research Support, N.I.H., Extramural)
CopyrightCopyright © 2019. Published by Elsevier Inc.
Topics
  • Adult
  • Aged
  • Aged, 80 and over
  • Hematopoietic Stem Cell Transplantation (adverse effects)
  • Humans
  • Lymphoma (therapy)
  • Middle Aged
  • Multiple Myeloma (therapy)
  • Neoplasm Recurrence, Local
  • Quality of Life
  • Survivorship
  • Transplantation, Autologous
  • Young Adult

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