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Gruber, Isabella ; Koelbl, Oliver ; Herr, Wolfgang ; Holler, Ernst ; Edinger, Matthias ; Wolff, Daniel

Impact of chronic graft-versus-host disease on quality of life and cognitive function of long-term transplant survivors after allogeneic hematopoietic stem cell transplantation with total body irradiation

Gruber, Isabella , Koelbl, Oliver, Herr, Wolfgang, Holler, Ernst, Edinger, Matthias und Wolff, Daniel (2022) Impact of chronic graft-versus-host disease on quality of life and cognitive function of long-term transplant survivors after allogeneic hematopoietic stem cell transplantation with total body irradiation. Radiation Oncology 17 (1), art.no.195.

Veröffentlichungsdatum dieses Volltextes: 08 Dez 2022 05:58
Artikel
DOI zum Zitieren dieses Dokuments: 10.5283/epub.53312


Zusammenfassung

Background Total body irradiation (TBI)-based-conditioning before allogeneic hematopoietic stem cell transplantation (allo-HSCT) is standard of care in patients with acute myeloid leukemia (AML) but can cause long-term morbidity. Data on the impact of chronic Graft-versus-host disease (cGvHD) on cognitive function (CF) and quality of life (QoL) of long-term transplant survivors are sparse. ...

Background Total body irradiation (TBI)-based-conditioning before allogeneic hematopoietic stem cell transplantation (allo-HSCT) is standard of care in patients with acute myeloid leukemia (AML) but can cause long-term morbidity. Data on the impact of chronic Graft-versus-host disease (cGvHD) on cognitive function (CF) and quality of life (QoL) of long-term transplant survivors are sparse. Methods We analyzed patient-reported outcomes focusing on progression-free AML patients and 1st allo-HSCT applying a standardized TBI-technique with an average dose rate of 4 cGy/min to the total body and lung shielding in case of doses > 8 Gy. Instruments included the Functional Assessment of Cancer Therapy-Bone marrow transplant (FACT-BMT, version 4), the FACT-Cognition Function (FACT-Cog, version 3) and the Patient Health Questionaire-4 (PHQ-4). We put focus on the impact of cGvHD and compared the results to normative data derived from the general population. Results Out of 41 eligible patients contacted, 32 (78.0%) patients with a medium follow-up of 154 months (Interquartile range 113, 191 months) participated in the study. Eleven patients (34.4%) had active cGvHD, 11 (34.4%) resolved cGvHD and 10 (31.3%) never had cGvHD. Patients with active cGvHD had poorer FACT-BMT, FACT-Cog and higher PHQ-4 scores compared to patients with resolved cGvHD or who never had cGvHD. Outcomes were similar in patients with resolved cGvHD and those who never had cGvHD. Patients with active cGvHD had similar FACT-Cog, but lower FACT-BMT in comparison to normative data. However, the overall patient sample had similar FACT-BMT and FACT-Cog in comparison to normative data. Conclusion Our data indicate that CF of long-term survivors upon TBI-based allo-HSCT is not impaired, even in the presence of active cGvHD. However, active cGvHD has a negative impact on QoL. Trial registration The local Ethics Board of the University of Regensburg approved this study (Number 20-1810_1-101).



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Details

DokumentenartArtikel
Titel eines Journals oder einer ZeitschriftRadiation Oncology
Verlag:BMC
Ort der Veröffentlichung:LONDON
Band:17
Nummer des Zeitschriftenheftes oder des Kapitels:1
Seitenbereich:art.no.195
Datum29 November 2022
InstitutionenMedizin > Lehrstuhl für Innere Medizin III (Hämatologie und Internistische Onkologie)
Medizin > Lehrstuhl für Strahlentherapie
Identifikationsnummer
WertTyp
10.1186/s13014-022-02161-9DOI
Stichwörter / KeywordsCONSENSUS DEVELOPMENT PROJECT; CLINICAL-TRIALS; DIAGNOSIS; CANCER; POPULATION; MORTALITY; CRITERIA; Total body irradiation; Acute myeloid leukemia; Chronic graft-versus-host disease; Allogeneic hematopoietic cell transplantation; Quality of life; Cognitive function
Dewey-Dezimal-Klassifikation600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin
StatusVeröffentlicht
BegutachtetJa, diese Version wurde begutachtet
An der Universität Regensburg entstandenJa
URN der UB Regensburgurn:nbn:de:bvb:355-epub-533129
Dokumenten-ID53312

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