Patient-reported outcomes in survivors of childhood hematologic malignancies with hematopoietic stem cell transplant

Abstract

Patient-reported outcomes among survivors of pediatric hematopoietic stem cell transplant (HSCT) are understudied. We compared symptom prevalence, health-related quality of life (HRQOL), and risk factors in adult survivors of childhood hematologic malignancies treated with HSCT to those treated with conventional therapy and noncancer controls. Survivors of childhood hematologic malignancies (HSCT N 5 112 [70% allogeneic, 30% autologous]; conventionally treated N 5 1106) and noncancer controls (N 5 242) from the St. Jude Lifetime Cohort Study completed surveys assessing 10 symptom domains and SF-36 HRQOL summary scores. Chronic health conditions (CHCs) were validated by clinical assessment. Multivariable logistic regression reveals that compared with noncancer controls, HSCT survivors endorsed a significantly higher symptom prevalence in sensation (OR 5 4.7, 95% confidence interval [CI], 2.6-8.4), motor/movement (OR 5 4.3, 95% CI, 1.6-11.0), pulmonary (OR 5 4.6, 95% CI, 1.8-11.8), and memory domains (OR 5 4.8, 95% CI, 2.5-9.2), and poorer physical HRQOL (OR 5 6.9, 95% CI, 2.8-17.0). HSCT and conventionally treated survivors had a similar prevalence of all symptom domains and HRQOL (all P >.05); however, HSCT survivors had a significantly higher cumulative prevalence for specific symptoms: double vision (P 5.04), very dry eyes (P