Survivorship after Autologous Hematopoietic Cell Transplantation for Lymphoma and Multiple Myeloma: Late Effects and Quality of Life: Late Effects and QOL after Auto-HCT

George E. Georges; Merav Bar; Lynn Onstad; Jean C. Yi; Mazyar Shadman; Mary E. Flowers; Paul A. Carpenter; Susan Stewart; Stephanie J. Lee; Leona A. Holmberg

doi:10.1016/j.bbmt.2019.10.002

Survivorship after Autologous Hematopoietic Cell Transplantation for Lymphoma and Multiple Myeloma: Late Effects and Quality of Life: Late Effects and QOL after Auto-HCT

George E. Georges^*, Merav Bar, Lynn Onstad, Jean C. Yi, Mazyar Shadman, Mary E. Flowers, Paul A. Carpenter, Susan Stewart, Stephanie J. Lee, Leona A. Holmberg

^*Corresponding author for this work

Medicine, Hematology Oncology Division

Research output: Contribution to journal › Article › peer-review

20 Scopus citations

Abstract

Although autologous hematopoietic cell transplantation (AHCT) is standard therapy for patients with lymphoma and multiple myeloma (MM), few studies have addressed late effects and quality of life (QoL) in long-term survivors after AHCT. Using long-term follow-up (LTFU) annual questionnaires with self-reported outcomes, we surveyed 665 patients who were at ≥5 years after AHCT for the diagnosis of lymphoma or MM. Three-hundred and eighty-nine patients completed the questionnaire (58% response rate) at a median of 11 years (range, 5-30 years) after AHCT. The median patient age was 63 years (range, 22-88 years) in the 268 patients with lymphoma and 69 years (range, 34-84 years) in the 121 patients with multiple myeloma. The most commonly reported medical conditions (>10% incidence) were sexual dysfunction, history of shingles, cataracts, osteoporosis or osteopenia, joint replacement, and skin cancer. Current medication use was more frequent in the patients with MM for infection prevention/treatment (19% for MM versus 5% lymphoma; P <. 001), hypertension (41% versus 26%; P =. 004), osteoporosis (23% versus 10%; P <. 001), and pain (32% versus 11%, P <. 001). Treated hypothyroidism was more common in lymphoma patients. In multivariate analysis combining lymphoma and MM, worse physical functioning was associated with older age, shorter interval since AHCT, comorbidities, relapse, and treatment for depression and/or pain. Worse mental functioning was associated with younger age and treatment for anxiety, depression, or pain. In conclusion, AHCT survivors report generally good QoL but many late effects and symptoms that are potentially amenable to intervention.

Original language	English (US)
Pages (from-to)	407-412
Number of pages	6
Journal	Biology of Blood and Marrow Transplantation
Volume	26
Issue number	2
DOIs	https://doi.org/10.1016/j.bbmt.2019.10.002
State	Published - Feb 2020

Funding

The authors thank the patients who completed the LTFU surveys for participating in this study. Financial disclosure: Funding source: CA18029 from the National Cancer Institute, National Institutes of Health, Department of Health and Human Services. Conflict of interest statement: Holmberg: up-to-date (royalties). Authorship statement: All authors designed the research, analyzed data, and edited the paper. G.E.G. S.J.L. and L.A.H. wrote the paper. Financial disclosure: See Acknowledgments on page 411. The authors thank the patients who completed the LTFU surveys for participating in this study. Financial disclosure: Funding source: CA18029 from the National Cancer Institute , National Institutes of Health , Department of Health and Human Services . Conflict of interest statement: Holmberg: up-to-date (royalties). Authorship statement: All authors designed the research, analyzed data, and edited the paper. G.E.G., S.J.L., and L.A.H. wrote the paper.

Keywords

Autologous hematopoietic cell transplantation
Late effects
Lymphoma
Multiple myeloma
Quality of life

ASJC Scopus subject areas

Transplantation
Hematology

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.bbmt.2019.10.002

Cite this

Georges, G. E., Bar, M., Onstad, L., Yi, J. C., Shadman, M., Flowers, M. E., Carpenter, P. A., Stewart, S., Lee, S. J., & Holmberg, L. A. (2020). Survivorship after Autologous Hematopoietic Cell Transplantation for Lymphoma and Multiple Myeloma: Late Effects and Quality of Life: Late Effects and QOL after Auto-HCT. Biology of Blood and Marrow Transplantation, 26(2), 407-412. https://doi.org/10.1016/j.bbmt.2019.10.002

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title = "Survivorship after Autologous Hematopoietic Cell Transplantation for Lymphoma and Multiple Myeloma: Late Effects and Quality of Life: Late Effects and QOL after Auto-HCT",

abstract = "Although autologous hematopoietic cell transplantation (AHCT) is standard therapy for patients with lymphoma and multiple myeloma (MM), few studies have addressed late effects and quality of life (QoL) in long-term survivors after AHCT. Using long-term follow-up (LTFU) annual questionnaires with self-reported outcomes, we surveyed 665 patients who were at ≥5 years after AHCT for the diagnosis of lymphoma or MM. Three-hundred and eighty-nine patients completed the questionnaire (58% response rate) at a median of 11 years (range, 5-30 years) after AHCT. The median patient age was 63 years (range, 22-88 years) in the 268 patients with lymphoma and 69 years (range, 34-84 years) in the 121 patients with multiple myeloma. The most commonly reported medical conditions (>10% incidence) were sexual dysfunction, history of shingles, cataracts, osteoporosis or osteopenia, joint replacement, and skin cancer. Current medication use was more frequent in the patients with MM for infection prevention/treatment (19% for MM versus 5% lymphoma; P <. 001), hypertension (41% versus 26%; P =. 004), osteoporosis (23% versus 10%; P <. 001), and pain (32% versus 11%, P <. 001). Treated hypothyroidism was more common in lymphoma patients. In multivariate analysis combining lymphoma and MM, worse physical functioning was associated with older age, shorter interval since AHCT, comorbidities, relapse, and treatment for depression and/or pain. Worse mental functioning was associated with younger age and treatment for anxiety, depression, or pain. In conclusion, AHCT survivors report generally good QoL but many late effects and symptoms that are potentially amenable to intervention.",

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author = "Georges, {George E.} and Merav Bar and Lynn Onstad and Yi, {Jean C.} and Mazyar Shadman and Flowers, {Mary E.} and Carpenter, {Paul A.} and Susan Stewart and Lee, {Stephanie J.} and Holmberg, {Leona A.}",

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Georges, GE, Bar, M, Onstad, L, Yi, JC, Shadman, M, Flowers, ME, Carpenter, PA, Stewart, S, Lee, SJ & Holmberg, LA 2020, 'Survivorship after Autologous Hematopoietic Cell Transplantation for Lymphoma and Multiple Myeloma: Late Effects and Quality of Life: Late Effects and QOL after Auto-HCT', Biology of Blood and Marrow Transplantation, vol. 26, no. 2, pp. 407-412. https://doi.org/10.1016/j.bbmt.2019.10.002

Survivorship after Autologous Hematopoietic Cell Transplantation for Lymphoma and Multiple Myeloma: Late Effects and Quality of Life: Late Effects and QOL after Auto-HCT. / Georges, George E.; Bar, Merav; Onstad, Lynn et al.
In: Biology of Blood and Marrow Transplantation, Vol. 26, No. 2, 02.2020, p. 407-412.

Research output: Contribution to journal › Article › peer-review

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AU - Bar, Merav

AU - Onstad, Lynn

AU - Yi, Jean C.

AU - Shadman, Mazyar

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AB - Although autologous hematopoietic cell transplantation (AHCT) is standard therapy for patients with lymphoma and multiple myeloma (MM), few studies have addressed late effects and quality of life (QoL) in long-term survivors after AHCT. Using long-term follow-up (LTFU) annual questionnaires with self-reported outcomes, we surveyed 665 patients who were at ≥5 years after AHCT for the diagnosis of lymphoma or MM. Three-hundred and eighty-nine patients completed the questionnaire (58% response rate) at a median of 11 years (range, 5-30 years) after AHCT. The median patient age was 63 years (range, 22-88 years) in the 268 patients with lymphoma and 69 years (range, 34-84 years) in the 121 patients with multiple myeloma. The most commonly reported medical conditions (>10% incidence) were sexual dysfunction, history of shingles, cataracts, osteoporosis or osteopenia, joint replacement, and skin cancer. Current medication use was more frequent in the patients with MM for infection prevention/treatment (19% for MM versus 5% lymphoma; P <. 001), hypertension (41% versus 26%; P =. 004), osteoporosis (23% versus 10%; P <. 001), and pain (32% versus 11%, P <. 001). Treated hypothyroidism was more common in lymphoma patients. In multivariate analysis combining lymphoma and MM, worse physical functioning was associated with older age, shorter interval since AHCT, comorbidities, relapse, and treatment for depression and/or pain. Worse mental functioning was associated with younger age and treatment for anxiety, depression, or pain. In conclusion, AHCT survivors report generally good QoL but many late effects and symptoms that are potentially amenable to intervention.

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Survivorship after Autologous Hematopoietic Cell Transplantation for Lymphoma and Multiple Myeloma: Late Effects and Quality of Life: Late Effects and QOL after Auto-HCT

Abstract

Funding

Keywords

ASJC Scopus subject areas

UN SDGs

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