Psychological and physical function in allogeneic hematopoietic cell transplant survivors with chronic graft-versus-host disease

• Published in: Journal of cancer survivorship Vol. 17; no. 3; pp. 646 - 656
• Main Authors: Hansen, Jenna L., Juckett, Mark B., Foster, Mikayla A., Rumble, Meredith E., Morris, Keayra E., Hematti, Peiman, Costanzo, Erin S.
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.06.2023; Springer Nature B.V
• Subjects: Adult; Allografts; Anxiety; Bronchiolitis Obliterans Syndrome; Cancer Survivors; Chronic Disease; Cognition; Fatigue; Gastrointestinal tract; Graft versus host disease; Graft vs Host Disease - diagnosis; Graft vs Host Disease - etiology; Graft vs Host Disease - psychology; Graft-versus-host reaction; Health Informatics; Health Promotion and Disease Prevention; Hematopoietic Stem Cell Transplantation - adverse effects; Hematopoietic stem cells; Humans; Insomnia; Medicine; Medicine & Public Health; Oncology; Pain; Primary Care Medicine; Public Health; Quality of Life Research; Signs and symptoms; Skin; Sleep disorders; Stem cell transplantation; Survival; Survivors; Transplantation; Transplantation, Homologous - adverse effects; Transplants & implants; Chronic graft-versus-host disease; Depression; Anxiety; Pain; Hematopoietic cell transplant; Sexual function
• ISSN: 1932-2259; 1932-2267
• DOI: 10.1007/s11764-023-01354-9

Purpose Chronic graft-versus-host disease (cGVHD) is a common late complication of allogeneic hematopoietic cell transplantation (HCT). This study comprehensively evaluated physical and psychological function among individuals with cGVHD. Additional aims were to investigate relationships between disease severity and psychological and physical function, and to investigate patterns of psychological and physical function by disease site. Method Adults at least 6 months post allogeneic HCT were enrolled and either had cGVHD ( n  =59) or served as a reference sample of HCT survivors with no cGVHD history ( n  = 19). Participants completed self-report measures of depression, anxiety, fatigue, insomnia, pain, cognition, and sexual function and had a comprehensive clinical evaluation of cGVHD using NIH consensus scoring criteria. Participants with cGVHD were stratified by disease severity and site and compared to the reference group with no cGVHD. Results Participants with mild cGVHD had comparable psychological and physical symptoms to the reference sample, while participants with moderate cGVHD experienced more severe anxiety and problems with sexual function, and participants with severe cGVHD experienced more severe depressive symptoms and pain compared to the reference sample. Participants with cGVHD manifesting in the skin and GI tract had the most severe symptoms, including mood disturbance, fatigue, and pain. Conclusions and Implications for Cancer Survivors Results suggest that patients with more severe cGVHD and those with cGVHD manifesting in the skin, GI tract, and lungs are at risk for poorer psychological and physical outcomes and may benefit from proactive interventions to optimize function.