Henrietta Janicsák, Tamás Masszi, Péter Reményi, Gabor S Ungvari, Gábor Gazdag
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引用次数: 0
Abstract
Background and purpose:
Despite the decrease in transplant-related mortality, patients who receive hematopoietic stem-cell transplants often suffer from short-and long-term morbidities, poorer quality of life, and psychosocial functioning deficits. Several studies have compared the quality of life and affective symptoms of patients after undergoing autologous and allogeneic hematopoietic stem-cell transplants. Some studies have reported similar or greater quality of life impairments in allogeneic hematopoietic stem-cell recipients, but the findings have been inconsistent. Our purpose was to examine the influence of the type of hematopoietic stem-cell transplantation on the quality of life and affective symptoms of patients.
.
Methods:
The study sample comprised 121 patients with various hematological diseases who underwent hematopoietic stem-cell transplantation at St. István and St. László Hospitals, Budapest. The study had a cross-sectional design. Quality of life was evaluated using the Hungarian version of the Functional Assessment of Cancer Therapy–Bone Marrow Transplant scale (FACT-BMT). Anxiety and depressive symptoms were assessed using Spielberger’s State and Trait Anxiety Inventory (STAI) and the Beck Depression Inventory (BDI), respectively. Basic sociodemographic and clinical variables were also recorded. Comparisons between autologous and allogeneic recipients were analyzed using a t-test when the variables were normally distributed and a Mann–Whitney U test otherwise. A stepwise multiple linear regression analysis was performed to identify the risk factors that contributed to the quality of life and the affective symptoms in each group.
.
Results:
Quality of life (p=0.83) and affective symptoms (pBDI=0.24; pSSTAI=0.63) were similar between the autologous and allogeneic transplant groups. The BDI scores of allogeneic transplant patients indicated mild depression, but their STAI scores were similar to those of the general population. Allogeneic transplant patients with symptoms of graft-versus-host disease (GVHD) experienced more severe clinical conditions (p=0.01), poorer functional status (p<0.01) and received more immunosuppressive treatment (p<0.01) than those without graft versus host disease. Patients suffering from graft versus host disease experienced more severe depression (p=0.01), and constant anxiety (p=0.03) than those without graft versus host disease. Quality of life was affected by depressive and anxiety symptoms and psychiatric comorbidity in both the allogeneic and autologous groups.
.
Conclusion:
Graft versus host disease-related severe somatic complaints seemed to influence the allogeneic transplant patients’ quality of life by inducing depressive and anxiety symptoms.
背景和目的:尽管移植相关死亡率降低,但接受造血干细胞移植的患者经常遭受短期和长期发病率、生活质量较差和社会心理功能缺陷的困扰。一些研究比较了自体和异体造血干细胞移植后患者的生活质量和情感症状。一些研究报告同种异体造血干细胞受体存在类似或更严重的生活质量损害,但研究结果不一致。我们的目的是研究造血干细胞移植类型对患者生活质量和情感症状的影响。方法:研究样本包括121例在St. István和St. Lá sá医院,布达佩斯。该研究采用横断面设计。使用匈牙利版肿瘤治疗功能评估和骨髓移植量表(FACT-BMT)评估生活质量。焦虑和抑郁症状分别采用斯皮尔伯格状态与特质焦虑量表(STAI)和贝克深度抑郁量表(BDI)进行评估。基本的社会人口学和临床变量也被记录下来。当变量为正态分布时,采用t检验分析自体和异体受体之间的比较,否则采用Mann–Whitney U检验。采用逐步多元线性回归分析确定影响各组患者生活质量和情感症状的危险因素。结果:生活质量(p=0.83)和情感症状(pBDI=0.24;pSSTAI=0.63)在自体和异体移植组间差异无统计学意义。同种异体移植患者的BDI评分显示轻度抑郁,但其STAI评分与一般人群相似。同种异体移植后出现移植物抗宿主病(GVHD)症状的患者比无移植物抗宿主病的患者有更严重的临床症状(p=0.01)、更差的功能状态(p<0.01)和更多的免疫抑制治疗(p<0.01)。患有移植物抗宿主病的患者比没有移植物抗宿主病的患者有更严重的抑郁(p=0.01)和持续焦虑(p=0.03)。同种异体移植患者和自体异体移植患者的生活质量均受抑郁、焦虑症状和精神共病的影响。结论:移植物抗宿主病相关的严重躯体疾患可能影响同种异体移植患者的生活质量。通过诱导抑郁和焦虑症状影响生活质量。
期刊介绍:
The aim of Clinical Neuroscience (Ideggyógyászati Szemle) is to provide a forum for the exchange of clinical and scientific information for a multidisciplinary community. The Clinical Neuroscience will be of primary interest to neurologists, neurosurgeons, psychiatrist and clinical specialized psycholigists, neuroradiologists and clinical neurophysiologists, but original works in basic or computer science, epidemiology, pharmacology, etc., relating to the clinical practice with involvement of the central nervous system are also welcome.