Long-term cancer survivors report that health complications arising after bone marrow transplantation impact their physical well-being, but not their psychological or spiritual well-being, according to a study led by Smita Bhatia, M.D., M.P.H., director of City of Hope’s Division of Population Sciences.
Researchers announced findings from their investigation — the first study of adult survivors of hematopoietic cell transplantation (HCT) to examine the relationship between long-term complications and quality of life — at the 48th American Society of Hematology Annual Meeting in Orlando, Fla., in December. Can-Lan Sun, Ph.D., assistant research scientist in population sciences, presented the results.
Physicians conduct more than 45,000 HCT procedures each year to treat a variety of life-threatening diseases, such as leukemia. More than 100,000 transplant survivors today have survived for five years or more. However, due to their HCT treatment, which includes chemotherapy, radiation and immunosuppressive drugs, survivors are at increased risk of developing a wide-range of complications that may significantly affect their lives.
“The goal of the study was to examine the impact of long-term health complications on the quality of life in long-term transplant survivors. The surveys revealed that not all health complications are equal, and only some, not all, complications have a negative impact on survivors’ overall quality of life,” said Bhatia. “Many cancer survivors believe that their lives will return to normal after treatment. So, it is the problems that they encounter during their daily routines that they see as truly impacting their quality of life.”
Researchers collected surveys from 1,013 cancer survivors who underwent HCT procedures at either City of Hope or the University of Minnesota. Called the Bone Marrow Transplant Survivors Study, the investigation examines survivors’ long-term complications and assessed their health-related quality of life, which is broken down into physical, psychological, social and spiritual aspects, as well as overall quality of life categories.
Investigators compiled information on complications such as impaired hearing, vision problems, speech difficulties, dental problems, cardiac dysfunction, stroke, hip-joint replacement, pulmonary problems, gastrointestinal distress and neurologic conditions. Adjustments were made for certain factors, including inability to return to work, pain or anxiety, marital status, age and gender.
Patients reported that physical well-being was most affected by complications that caused hearing, speech, dental, cardiopulmonary, gastrointestinal and neurological problems. Similarly, survivors rated speech, dental, gastrointestinal and neurologic problems as the most detrimental to their social well-being. While individual patient response varied, on the whole, complications had no statistically significant influence on psychological well-being, and stroke was the only complication that impacted spiritual well-being.
“There have been studies that identified complications from HCT, and other studies that described patient quality of life, but this is the first that examines the impact of complications on quality of life, which can help us better understand the needs of cancer survivors,” said Bhatia. “Data from this study raise awareness of the impact of treatment-related complications and suggest areas to investigate during follow-up care. The data should help us develop appropriate interventions for HCT patients to enable a better quality of life after cancer treatment.”
