Changes in quality of life and nutritional status following high dose conditioning and stem cell transplantation — ASN Events

Changes in quality of life and nutritional status following high dose conditioning and stem cell transplantation (#123)

Yun-Chi YH Hung 1 , Judith JB Bauer 1 , Pamela PH Horsley 2 , Mary MW Waterhouse 3 , John JB Bashford 4 , Elisabeth EI Isenring 1
  1. The University of Queensland, Brisbane, QLD, Australia
  2. Nutrition Services, The Wesley Hospital, Brisbane, Queensland, Australia
  3. The Wesley Research Institute, Brisbane, Queensland, Australia
  4. Haematology & Oncology Clinics of Australasia, Brisbane, Queensland, Australia

Little is known about changes in the nutritional status and quality of life (QoL) following high dose conditioning and stem cell transplantation (SCT). The assessment of nutritional status and QoL are valuable measures for the long term follow up of cancer survivors; in addition, results may have implications on the development, or the evaluation of patient-orientated care. Objective: To determine the proportion of SCT survivors whose scores for QoL and functioning subscales (physical (PF), role (RF), cognitive (CF), and social (SF) remain adversely affected at 100 days post-transplantation compared to pre-admission; and to examine if changes in global QoL is associated with nutritional status. Methods: Assessments were conducted at 2 weeks pre-admission (T0), and 100-days post-transplantation (T2): nutritional status was assessed by the Patient-Generated Subjective Global Assessment (PG-SGA); QoL, and functioning subscales were assessed using the: EORTC QLQ-C30. Score change for QoL and functioning between T0 to T2 were evaluated for clinical significance using the recently published, evidence-based guideline for interpreting EORTC QLQ-C30 by Cocks et al. (2011). EF was not determined by the guideline and therefore could not be examined. Results: 28 consecutive cancer patients undergoing SCT were recruited (64% male; mean age 56±12.3 years; 24 autologous-SCT). At 100 days, the proportion of SCT patients whose QoL and functioning remained lower than baseline with clinical significance were: 33% QoL, 38% PF, 38% RF, 17% CF, and 25% SF. Higher global QoL between T0 and T2 was associated with less nutritional symptoms (i.e. low PG-SGA score) (r= 0.56, p=0.007), and weight (r= 0.5, p=0.018). Conclusions: The adverse effect of HDC and SCT on QoL, and functioning sub-scales are not completely reversed amongst a sub-group of SCT patients up to 100 days post-transplantation. Changes in QoL may be associated with nutritional status. Findings suggest certain patients may require ongoing support from health professionals to address nutritional issues which may potentially affect their long term QoL.