The Quality of Life of Adult Survivors of Childhood Hematopoietic Cell Transplant

Survival rates following myeloablative hematopoietic cell transplantation (HCT) in childhood have improved. We conducted a cross-sectional study evaluating the quality of life (QOL) of 214 adult survivors of a childhood HCT compared to controls using standardized self report measures with strong psychometric properties to evaluate physical function, psychological function, and cognitive symptoms. From these results we conducted a multivariate analysis of risk factors. This analysis for physical functioning showed poorer function among myeloid disease survivors compared to patients with all other diagnoses (p=0.02), males functioned better than females (p=0.05) and those >18 years after transplant functioned more poorly than those <18 years after transplant (p=0.05). Psychological functioning showed those who received more therapy and females were more likely to be depressed (p=0.03) and (p=0.005). Perceived cognitive symptoms demonstrated that female survivors had more symptoms than male survivors (p=0.01), and those receiving more preceding therapy compared to those with less preceding therapy (p=0.001) or cranial irradiation compared to those without cranial irradiation (p=0.002) had more perceived cognitive symptoms. Overall, these data indicate the majority of adult survivors of a childhood transplant are functioning well, but some have problems which need to be addressed.