Symptoms trends after hematopoietic stem cell transplantation
Objective: To characterize patterns of symptom severity and determine interference of symptoms with daily activities after allogeneic and autologous hematopoietic stem cell transplantation (HSCT). Methods: A combined dataset of four different studies was used for the analysis with a total of 304 patients. MD Anderson Symptom Inventory – Bone Marrow Transplantation was the questionnaire used to evaluate symptoms severity and their interference with daily activities. These data were collected longitudinally. The analysis was based on each of the five worst symptoms and the mean of the worst five symptoms. The data were analyzed using linear mixed models, where time was the number of days from day of transplant. Results: The five worst symptoms based on the grand mean were fatigue, physical weakness, sleep disturbance, lack of appetite, and pain. Older patients reported more fatigue, physical weakness, and they had higher mean of the worst five symptoms. Male patients had significantly lower fatigue compared to female patients. Sleep disturbance was less in Hispanic compared to white non-Hispanic patients. The interaction between type of transplant and time was significant in the mean of the worst five symptoms, fatigue, physical weakness, and lack of appetite. However, time, without interaction with transplant type, was a significant predictor of sleep disturbance and pain. Symptom severity was significantly correlated with symptoms interference at all time points; strongest correlation was at day 30. Conclusion: Age and the interaction between types of transplant and time are the main factors that determine symptoms severity for the worst five symptoms. This information is valuable when managing patients’ symptoms after they had HSCT and to tailor interventions according to different patient’s characteristics.
Samargandy, Saad J, "Symptoms trends after hematopoietic stem cell transplantation" (2015). Texas Medical Center Dissertations (via ProQuest). AAI1603945.