Acute health-related quality of life in children undergoing stem cell transplant: I. Descriptive outcomes

Area of Science:

• Pediatric Hematology/Oncology
• Child Psychology
• Transplantation Medicine

Background:

• Limited empirical data exists on the acute psychological and somatic effects of bone marrow or stem cell transplant (BMT) in pediatric populations.
• Clinical observations suggest significant distress in children undergoing BMT, but this has not been systematically documented.
• Understanding these acute effects is crucial for developing effective supportive care strategies.

Purpose of the Study:

• To empirically document the acute effects of bone marrow or stem cell transplant (BMT) on children.
• To characterize the trajectory of distress in pediatric patients from admission through six months post-transplant.
• To compare parent and patient self-reports of distress during the BMT process.

Main Methods:

• A prospective, longitudinal study design involving 153 children undergoing BMT.
• Weekly assessments from admission to week +6 post-transplant, followed by monthly assessments up to month +6.
• Data collection using the BASES scales, incorporating both parent and patient (age 5+) reports.

Main Results:

• Children undergoing BMT exhibit elevated distress (somatic symptoms, mood disturbance, low activity) upon admission, which significantly increases post-conditioning.
• Distress peaks approximately one week after transplant and then transiently declines to admission levels by weeks +4 to +5.
• Distress levels continue to decrease, reaching presumed baseline by months 4-6, with similar trajectories reported by parents and patients.

Conclusions:

• Pediatric BMT patients experience a predictable, transient pattern of acute distress.
• Parent and child reports of distress during BMT are congruent, validating the observed patterns.
• Findings underscore the necessity for enhanced supportive care interventions to mitigate distress during the acute phase of pediatric BMT.