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Published on: August 31, 2016
Symptom Burden and Recovery in the First Year After Allogeneic Hematopoietic Stem Cell Transplantation
Linda Victoria Eriksson1, Katarina Holmberg, Carina Lundh Hagelin
1Author Affiliations: Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet (Mss Eriksson and Holmberg and Drs Lundh Hagelin, Wengström, Bergkvist, and Winterling); Department of Haematology, Karolinska University Hospital (Ms Eriksson and Dr Winterling); Department of Nursing, Sophiahemmet University (Ms Holmberg and Dr Bergkvist); Department of Health Care Sciences, Palliative Research Centre, Ersta Sköndal Bräcke University College (Dr Lundh Hagelin); and Cancer Theme, Breast Centre, Karolinska University Hospital (Dr Wengström), Stockholm, Sweden.
Background:
Patients are affected by various symptoms after allogeneic hematopoietic stem cell transplantation (allo-HSCT) that can affect recovery. Research has mainly focused on symptom occurrence; thus, little is known about patients' overall symptom burden.
Objective:
The aim of this study was to examine patient-reported symptom burden in the first year after allo-HSCT and whether a high symptom burden 4 months after allo-HSCT predicts recovery, that is, general health and sick leave, 1 year after transplantation.
Methods:
Allo-HSCT patients aged 18 to 65 years were included (n = 189). Questionnaire data were collected on admission to the allo-HSCT unit, as well as 4 and 7 months and 1 year after allo-HSCT. Logistic regression evaluated relationships between demographic characteristics, chronic graft-versus-host disease, physical activity, and a high symptom burden.
Results:
Tiredness, susceptibility to infection, disinterest in sex, and physical weakness remained the most frequent symptoms, while distressing symptoms varied during the first year after allo-HSCT.Poor general health 1 year after allo-HSCT was associated with older age, low physical activity, and a high symptom burden 4 months after allo-HSCT. Full-time sick leave 1 year after allo-HSCT was associated with chronic graft-versus-host disease, low physical activity, and a high symptom burden 4 months after transplantation.
Conclusions:
Experiencing a high symptom burden 4 months after allo-HSCT can affect recovery 1 year after transplantation. Furthermore, low physical activity 4 months after allo-HSCT can predict both general health and sick leave 1 year after transplantation.
Implications For Practice:
Repeated symptom assessment, including experienced distress, is central for reducing overall symptom burden and supporting recovery after allo-HSCT.
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