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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

Article

Gruber, Isabella , Koelbl, Oliver, Herr, Wolfgang, Holler, Ernst, Edinger, Matthias and 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.

DOI to cite this document: 10.5283/epub.53312


Abstract

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

Item typeArticle
Journal or Publication TitleRadiation Oncology
PublisherBMC
Open Access TypeDEAL (Springer Gold)
Place of PublicationLONDON
Volume17
Number of Issue or Book Chapter1
Page Rangeart.no.195
Date29 November 2022
Date of publication08 Dec 2022 05:58
InstitutionsMedicine > Lehrstuhl für Innere Medizin III (Hämatologie und Internistische Onkologie)
Medicine > Lehrstuhl für Strahlentherapie
Identification Number
ValueType
10.1186/s13014-022-02161-9DOI
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 Decimal Classification600 Technology > 610 Medical sciences Medicine
StatusPublished
RefereedYes, this version has been refereed
Created at the University of RegensburgYes
URN of the UB Regensburgurn:nbn:de:bvb:355-epub-533129
Item ID53312

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