Recovery and long-term function after hematopoietic cell transplantation for leukemia or lymphoma
Recovery and long-term function after hematopoietic cell transplantation for leukemia or lymphoma
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DOI：
10.1001/jama.291.19.2335
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发表时间：
2004-05-19
影响因子：
120.7
通讯作者：
Martin, PJ
中科院分区：
文献类型：
--
作者：
Syrjala, KL;Langer, SL;Martin, PJ
背景造血细胞移植（HCT）是一种有效且广泛应用于恶性血液病的治疗方法。HCT后的身体和情绪恢复的速度和预测因素还没有得到充分的定义，在前瞻性的长期study. ObjectiveTo检查的过程中恢复和返回工作后HCT.Design，Setting，and Patients前瞻性，纵向队列研究在美国学术中心专门从事HCT。对319名接受清髓性HCT治疗白血病或淋巴瘤并会说英语的成年人进行了从移植前到5年随访的功能评估。99长期生存者谁没有复发的恶性肿瘤，94完成5年follow-up.Main Outcome Measures身体限制，恢复工作，抑郁，痛苦相关的治疗或疾病进行了评估移植前，在90天，并在1，3，5年后HCT.Results身体恢复发生早于心理或工作恢复。仅21例患者（19%）在1年时恢复所有结局。5年时，无重大限制的比例增加至63%（n = 57）。在没有复发性恶性肿瘤的幸存者中，84%（n = 74）在5年内恢复全职工作。体力恢复较慢的患者有较高的医疗风险，HCT前抑郁程度更高（P <0.001）。慢性移植物抗宿主病患者（P = .01）、HCT前社会支持较少的患者（P = .001）和女性患者（P
Context Hematopoietic cell transplantation (HCT) is an effective and widely used treatment for hematologic malignancies. The rate and predictors of physical and emotional recovery after HCT have not been adequately defined in prospective long-term studies.Objective To examine the course of recovery and return to work after HCT.Design, Setting, and Patients Prospective, longitudinal cohort study at a US academic center specializing in HCT. Function was assessed from pretransplantation to 5-year follow-up for 319 adults who had myeloablative HCT for treatment of leukemia or lymphoma and spoke English. Of the 99 long-term survivors who had no recurrent malignancy, 94 completed 5-year follow-up.Main Outcome Measures Physical limitations, return to work, depression, and distress related to treatment or disease were evaluated before transplantation, at 90 days, and at 1, 3, and 5 years after HCT.Results Physical recovery occurred earlier than psychological or work recovery. Only 21 patients (19%) recovered on all outcomes at 1 year. The proportion without major limitations increased to 63% (n = 57) by 5 years. Among survivors without recurrent malignancy, 84% (n = 74) returned to full-time work by 5 years. Patients with slower physical recovery had higher medical risk and were more depressed before HCT (Pless than or equal to.001). Patients with chronic graft-vs-host disease (P = .01), with less social support before HCT (P = .001), and women (P