The quality of life of adult survivors of childhood hematopoietic cell transplant

Survival rates after 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 with 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 with patients with all other diagnoses (P = 0.02), men functioned better than women (P = 0.05) and those >18 years after transplant functioned more poorly than those <18 years after transplant (P = 0.05). Psychological functioning showed that those who received more therapy and females were more likely to be depressed (P = 0.03) and (P = 0.005). Perceived cognitive symptoms showed that female survivors had more symptoms than male survivors (P = 0.01), and those receiving more preceding therapy compared with those with less preceding therapy (P = 0.001) or cranial irradiation compared with those without cranial irradiation (P = 0.002) had more perceived cognitive symptoms. Overall, these data indicate that the majority of adult survivors of a childhood transplant are functioning well, but some have problems that need to be addressed. Bone Marrow Transplantation (2010) 45, 746-754; doi:10.1038/bmt.2009.224; published online 31 August 2009