Symptom Burden and Recovery in the First Year After Allogeneic Hematopoietic Stem Cell Transplantation : Cancer Nursing

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Symptom Burden and Recovery in the First Year After Allogeneic Hematopoietic Stem Cell Transplantation

Eriksson, Linda Victoria MSc, RN; Holmberg, Katarina MSc, RN; Lundh Hagelin, Carina PhD, RN; Wengström, Yvonne PhD, OCN; Bergkvist, Karin PhD, RN; Winterling, Jeanette PhD

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Cancer Nursing 46(1):p 77-85, 1/2 2023. | DOI: 10.1097/NCC.0000000000001077

Abstract

Background 

Patients are affected by various symptoms after allogeneic hematopoietic stem cell transplantation (allo-HSCT) that can affect recovery. Research has mainly focused on symptom occurrence; thus, little is known about patients’ overall symptom burden.

Objective 

The aim of this study was to examine patient-reported symptom burden in the first year after allo-HSCT and whether a high symptom burden 4 months after allo-HSCT predicts recovery, that is, general health and sick leave, 1 year after transplantation.

Methods 

Allo-HSCT patients aged 18 to 65 years were included (n = 189). Questionnaire data were collected on admission to the allo-HSCT unit, as well as 4 and 7 months and 1 year after allo-HSCT. Logistic regression evaluated relationships between demographic characteristics, chronic graft-versus-host disease, physical activity, and a high symptom burden.

Results 

Tiredness, susceptibility to infection, disinterest in sex, and physical weakness remained the most frequent symptoms, while distressing symptoms varied during the first year after allo-HSCT.

Poor general health 1 year after allo-HSCT was associated with older age, low physical activity, and a high symptom burden 4 months after allo-HSCT. Full-time sick leave 1 year after allo-HSCT was associated with chronic graft-versus-host disease, low physical activity, and a high symptom burden 4 months after transplantation.

Conclusions 

Experiencing a high symptom burden 4 months after allo-HSCT can affect recovery 1 year after transplantation. Furthermore, low physical activity 4 months after allo-HSCT can predict both general health and sick leave 1 year after transplantation.

Implications for Practice 

Repeated symptom assessment, including experienced distress, is central for reducing overall symptom burden and supporting recovery after allo-HSCT.

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