背景:异基因造血干细胞移植(allo-HSCT)与晚期并发症有关,这些并发症会损害患者移植后数年的生活质量(QoL)。本研究的目的是确定与未移植的成年人相比,在儿童期和青春期接受allo-HSCT的成年人的QoL差异。
方法:在这项前瞻性病例对照横断面研究中,我们纳入了年龄≥18岁,在儿童期或青春期接受allo-HSCT,随后在移植后存活至少2年的患者.对照组由年龄和性别相匹配的献血者组成。使用简短表格-36(SF-36)健康调查进行QoL评估,葡萄牙语版本2。
结果:包括34名移植患者和对照组。58.8%为男性,移植的中位年龄为13.5岁(范围,4-17年)。中位随访时间为11.5年(范围,2.0-23.0年)。最常见的晚期效果是骨骼,其次是内分泌并发症。患有这些晚期并发症的患者在以下方面的生活质量最差:身体功能,物理角色,身体疼痛,一般健康,和心理健康。与对照组相比,患者在两个方面得分较低:身体功能和身体角色.
结论:尽管儿童时期移植患者的骨骼和内分泌并发症对身体机能有影响,这些患者成年期的大多数QoL参数与相同年龄和性别的健康个体相似。早期发现和长期监测晚期并发症可以防止QoL受损。
BACKGROUND: Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is associated with late complications that can impair the quality of life (QoL) of patients for years after transplant. The purpose of the present study was to determine the difference in the QoL of adults that underwent allo-HSCT in childhood and adolescence compared with not transplanted adults.
METHODS: In this prospective
case-control cross-sectional study, we included patients aged ≥18 years that received an allo-HSCT during childhood or adolescence and subsequently survived at least 2 years after transplantation. The control group consisted of blood donors matched for age and sex. QoL assessment was performed using the Short Form-36 (SF-36) Health Survey, Portuguese version 2.
RESULTS: Thirty-four transplanted patients and controls were included. 58.8% were male, and the median age at transplant was 13.5 years (range, 4-17 years). The median follow-up was 11.5 years (range, 2.0-23.0 years). The most common late effect was skeletally followed by endocrine complications. Patients with these late complications had the worst QOL in the following dimensions: physical functioning, role physical, bodily pain, general health, and mental health. When compared to the control group, patients had a lower score in two dimensions: physical functioning and role physical.
CONCLUSIONS: Although skeletal and endocrine complications of transplant patients in childhood have an impact on physical functioning, most parameters of QoL of these patients in adulthood are similar to healthy individuals of the same age and gender. Early detection and long-term monitoring of late complications can prevent impairment of the QoL.