Survivors of allogeneic hematopoietic cell transplantation (allo-HCT) carry a high risk for toxicities later in life, yet minimal research has been done on the burden of these comorbidities and their impact on patients’ quality of life among recent long-term survivors of allo-HCT.
A recent study led by a team of researchers from Canada explored the burden of late toxicities and their influence on quality of life in patients who have undergone allo-HCT by comparing and quantifying the experience of those patients to that of their biological siblings. In addition, the investigators highlighted that they “aimed to understand the association of transplant-related variables, demographic variables, and comorbidities, with QoL [quality of life] amongst recipients.”
To facilitate the comparison, researchers built multivariable models to examine predictors of physical and mental health–related quality of life in transplant recipients. They explained that recipients without active chronic graft-vs-host disease (GVHD) or relapses “were enrolled at one of two survivorship clinics alongside their siblings.” The Patient-Reported Outcomes Measurement Information System (PROMIS) Global Health instrument was used to examine quality of life, and the post-transplant multimorbidity index was used to assess comorbidities.
A total of 391 patients were recruited for the study, 106 of which had siblings who also participated. One hundred and fifty-four siblings were “enrolled for comparison.” The results revealed that the 106 patients whose siblings were enrolled “experienced significantly more comorbidities versus their siblings.”
Furthermore, 51.9% of transplant recipients reported three or more comorbidities compared with 33.1% of siblings, and “at least 1 severe comorbidity was observed in 24.5% versus 13%, respectively.” Although patients who were survivors of allo-HCT experienced more comorbidities than their siblings, quality of life in both physical and mental health domains was found to be similar in the two groups.
The investigators also assessed social functioning as a contributing factor to quality of life, which was “rated as very good or excellent by 65.1% of recipients versus 68.6% of siblings (p=0.33).” Overall, the results illustrated that the number of comorbidities and social functioning were “strongly associated” with overall quality of life. In contrast, transplant-related variables such as graft and donor type and prior chronic GVHD, among others, were not strongly associated.
In reflecting on the results, the researchers highlighted that although patients who have received allo-HCT “continue to experience excess comorbidities versus their biological siblings,” overall quality of life and social functioning across both groups were comparable.