Turkiye Klinikleri Journal of Medical Sciences

.: ORIGINAL RESEARCH
Evaluation of Health Related Quality of Life Using Short-Form 36 Among Allogeneic Stem Cell Transplant Patients After at Least Two Years of Recovery: A Cross Sectional Observational Study
En Az İki Yıllık İyileşme Dönemi Ardından Allojenik Kök Hücre Nakli Hastalarında Kısa-Form 36 Kullanılarak Sağlıkla İlgili Yaşam Kalitesinin Değerlendirilmesi: Bir Kesitsel Gözlem Çalışması
Muhammed Mert SONKAYAa, Osman KARAb
aBahçeşehir University Faculty of Medicine, İstanbul, Türkiye
bDivision of Hematology, Bahçeşehir University Faculty of Medicine, İstanbul, Türkiye
Turkiye Klinikleri J Med Sci. 2023;43(1):75-82
doi: 10.5336/medsci.2022-92526
Article Language: EN
Full Text
ABSTRACT
 Objective: The use of allogeneic stem cell transplantation (allo-SCT) is increasing and patients are facing physical and mental problems during and after this process. In this study, it was aimed to evaluate the quality of life (QoL) of the patients after at least two or more years from allo-SCT. Material and Methods: 51 transplant patients (TxPs) and 54 healthy controls included in the study. Participants were asked to fill Short Form-36 survey which evaluates QoL in eight main domains. Comparison between TxPs and healthy controls, correlation analyses between remission duration and well being, ROC analysis to find a cut-off value for returning to healthy days were performed. Results: TxPs reported worse QoL than healthy controls. In terms of sex only mental health domain was significantly different where female pariticipants showed better results (p=0.01). Acute or chronic graft versus host disease were not found to have an effect on QoL (p>0.05). Relapsed disease formation had a reducing effect in QoL. Transplant related complications, cytomegalovirus reactivation, conditioning regimen type did not show statistically significant effect on QoL. As the results of the ROC analyses, post-transplant 46th month is found to be a turning point for recovery to healthy status with 68.6% sensitivity and 62.5% spesificity when patients start to realize they regain their health. Conclusion: Allo-SCT has negative effects on patients' physical and social life. In this study it was found that patients start to report similar results to healthy controls in health change approximately after two years from transplantation and the negative effects of transplant were almost completely ceased by 3.5 years.

Keywords: Allogeneic stem cell transplantation; quality of life; surveys and questionnaries
ÖZET
 Amaç: Allojenik kök hücre nakli [allogeneic stem cell transplantation (allo-SCT)] kullanımı giderek artmaktadır. Hastalar bu süreç boyunca ve sonrasında, fiziksel ve ruhsal sorunlarla karşı karşıya kalmaktadır. Bu çalışmada, allo-SCT'den en az 2 yıl sonra hastaların yaşam kalitesinin [quality of life (QoL)] değerlendirilmesi amaçlanmıştır. Gereç ve Yöntemler: Çalışmaya 51 nakil hastası [transplant patients (TxPs)] ve 54 sağlıklı kontrol dâhil edildi. Katılımcılardan QoL'yi 8 ana alanda değerlendiren Kısa Form-36 anketini doldurmaları istendi. TxPs ve sağlıklı kontroller arasında karşılaştırma, remisyon süresi ile iyilik hâli arasında korelasyon analizleri, sağlıklı günlere dönüş için bir eşik değeri bulmak için ROC analizi yapıldı. Bulgular: Çoğunlukla TxPs, sağlıklı kontrollerden daha kötü QoL bildirdi. Cinsiyet açısından tek fark ruh sağlığı karşılaştırmasında bulundu ve kadın katılımcıların daha iyi sonuçlar verdiği gözlemlendi (p=0,01). Akut veya kronik graft versus host hastalığının QoL üzerinde bir etkisi bulunmamıştır (p>0,05). Nükseden hastalık oluşumu QoL'de azaltıcı bir etkiye sahip olarak bulundu. Nakil ile ilgili komplikasyonlar, sitomegalovirüs reaktivasyonu, hazırlık rejimi tipi, QoL üzerinde istatistiksel olarak anlamlı bir etki göstermedi. ROC analizlerinin sonuçlarına göre %68,6 sensitivite ve %62,5 spesifite ile transplant sonrası 46. ay, hastaların sağlıklarına kavuştuklarını fark etmeye başlamaları açısından eşik değeri olarak bulunmuştur. Sonuç: allo-SCT'nin hastaların fiziksel ve sosyal yaşamları üzerinde olumsuz etkileri vardır. Bu çalışmada, hastaların nakilden yaklaşık 2 yıl sonra sağlık değişikliğinde sağlıklı kontrollere benzer sonuçlar vermeye başladıkları ve 3,5 yıl sonra naklin olumsuz etkilerinin neredeyse tamamen ortadan kalktığı bulunmuştur.

Anahtar Kelimeler: Allojenik kök hücre nakli; yaşam kalitesi; sörveyler ve anketler
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