目的:本研究旨在探讨造血干细胞移植(HSCT)后不同时间点患者报告的项目与长期生存之间的关系。
方法:我们对144例同种异体HSCT患者进行了一项研究,移植后跟踪他们5年。在移植前和移植后1、3、6、12、18、36和60个月收集来自癌症治疗-骨髓移植功能评估(FACT-BMT)问卷的数据。还评估了人口统计学特征和生存状态。
结果:144例中,5年总生存期(OS),无进展生存期(PFS),非复发死亡率(NRM),移植物抗宿主无病(GRFS)率为65%,48%,17%,分别为36%。与健康相关的生活质量(HRQOL)在5年内表现出波动模式。使用潜在类混合模型,在60个月随访期间,根据患者的身体健康状况(PWB)评分将患者分为两组.1级最初的PWB分数较低,随着时间的推移逐渐增加。相比之下,2级保持较高的PWB分数,随着时间的推移略有增加。Kaplan-Meier生存分析显示,1级有更好的OS(70.9%vs.52.9%,p=0.021),PFS(60.5%与41.2%,p=0.039),和GRFS(35.1%与29.3%,p=0.035)与2类相比。
结论:HSCT后初始PWB评分较高的患者长期生存结局改善。PWB评分可作为预测HSCT预后的重要指标。
OBJECTIVE: This study aimed to explore the association between patient-reported items at different time points after hematopoietic stem cell transplantation (HSCT) and long-term survival.
METHODS: We conducted a study with 144 allogeneic HSCT patients, following them for 5 years post-transplantation. Data from the Functional Assessment of Cancer Therapy-Bone Marrow Transplant (FACT-BMT) questionnaire were collected before transplantation and at 1, 3, 6, 12, 18, 36, and 60 months after transplantation. Demographic characteristics and survival status were also assessed.
RESULTS: Among the 144 cases, the 5-year overall survival (OS), progression-free survival (PFS), non-relapse mortality (NRM), and graft-versus-host disease-free (GRFS) rates were 65%, 48%, 17%, and 36% respectively. Health-related quality of life (HRQOL) showed a fluctuating pattern over 5 years. Using a latent class mixed model, patients were classified into two groups based on their physical well-being (PWB) scores during the 60-month follow-up. Class 1 had initially lower PWB scores, which gradually increased over time. In contrast, Class 2 maintained higher PWB scores with slight increases over time. Kaplan-Meier survival analysis revealed that Class 1 had better OS (70.9% vs. 52.9%, p = 0.021), PFS (60.5% vs. 41.2%, p = 0.039), and GRFS (35.1% vs. 29.3%, p = 0.035) compared to Class 2.
CONCLUSIONS: Patients who had higher initial PWB scores after HSCT demonstrated improved long-term survival outcomes. The PWB score could serve as a valuable predictor for the prognosis of HSCT.