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. 2017 Aug;143(8):1613-1619.
doi: 10.1007/s00432-017-2424-4. Epub 2017 Apr 19.

Physical and psychosocial aspects of adolescent and young adults after allogeneic hematopoietic stem-cell transplantation: results from a prospective multicenter trial

Kristin Pulewka  1   2 , Daniel Wolff  3 , Philipp Y Herzberg  4 , Hildegard Greinix  5 , Pia Heussner  6 , Friederike H A Mumm  6 , Stephanie von Harsdorf  7 , Kathrin Rieger  8 , Philipp Hemmati  8 , Andreas Hochhaus  2 , Inken Hilgendorf  9
Affiliations

Physical and psychosocial aspects of adolescent and young adults after allogeneic hematopoietic stem-cell transplantation: results from a prospective multicenter trial

Kristin Pulewka et al. J Cancer Res Clin Oncol. 2017 Aug.

Abstract

Purpose: Allogeneic hematopoietic stem-cell transplantation (alloHSCT) is physically and psychosocially demanding. Among transplant recipients, adolescent and young adults (AYA) represent a special group, as disease occurs early in life, resulting in the prospect of long survival time and high burden of alloHSCT sequelae. However, data focusing on AYA undergoing alloHSCT are rare.

Methods: Data resulting from a prospective multicenter trial initially focusing on graft-versus-host disease (GvHD) after alloHSCT were reused to analyse the differences between AYA and elderly patients. In total, data of 205 alloHSCT recipients were evaluated. Patients completed the FACT-BMT, HAP, SF-36, 24-AM, LOT-R, BSSS, HADS, and GvHD questionnaires.

Results: Median age of AYA and non-AYA patients was 29 and 52 years. Using 24-AM-Test, evaluating personality traits, non-AYA reported to be more conscientious (p = 0.033). However, AYA described higher quality of life regarding physical role functioning (p = 0.001), physical functioning (p = 0.002), bodily pain (p = 0.023), and emotional role function (p = 0.027) in the SF-36. General health perception, vitality, social role functioning, and mental health were comparable among both groups. On HAP scale, AYA reported higher maximum (p = 0.003) and adjusted activity scores (p = 0.002), but showed similar restrictions regarding activity, self-supply, and self-determination.

Conclusion: AYA represent a particular group characterized by higher physical well-being and activity scores, and significantly vary from non-AYA patients in psychosocial aspects. Studies covering distinctive features of AYA undergoing alloHSCT are warranted to improve awareness of the special needs of this group.

Keywords: Adolescents and young adults (AYA); Psycho-oncology; Quality of life; Stem-cell transplantation.

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Conflict of interest statement

All authors declare no conflicts of interest.

Figures

Fig. 1
Fig. 1
Short Form-36 (SF-36) health survey scales in AYA and non-AYA patients. Data are presented as mean ± standard deviation. Asterisk indicates statistical significant differences (p < 0.05) between groups
Fig. 2
Fig. 2
Functional assessment of cancer therapy-bone marrow transplantation (FACT-BMT) scales in AYA and non-AYA patients. Data are presented as mean ± standard deviation. Asterisk indicates statistical significant differences (p < 0.05) between groups. PWB physical well-being, SWB social/family well-being, EWB emotional well-being, FWB functional well-being, FACTG general functional assessment of cancer therapy, BMTS bone marrow transplantation subscale, TOI trial outcome index
Fig. 3
Fig. 3
Human activity profile (HAP) in AYA and non-AYA patients. Data are presented as mean ± standard deviation. Asterisk indicates statistical significant differences (p < 0.05) between groups. MAS maximum activity score, AAS adjusted activity score
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