QUALITY OF LIFE FOLLOWING BONE MARROW TRANSPLANTATION

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The use of bone marrow transplantation (BMT) as treatment for a variety of life threatening diseases has increased markedly in recent years. Prospects for longterm survival following BMT have also increased. Nevertheless, little is known about the quality of life evidenced by survivors of allogeneic BMT. Nothing is known about the quality of life of survivors of autologous BMT. The scant research that exists suggests wide variability in the quality of life of adult BMT survivors. While some patients exhibit few post-BMT complications and evidence an essentially "normal" quality of life, other patients evidence a variety of residual difficulties. Knowledge of post-BMT quality of life is essential for (a) the process of informed consent, (b) identification of post-BMT rehabilitation needs and the development of interventions to enhance post-BMT quality of life, and (c) analysis of the relative costs and benefits associated with BMT. Using a retrospective, longitudinal design, the proposed research will assess quality of life in a sample of 150 adult BMT patients at least 1 year post-BMT. All patients will have undergone either autologous or allogeneic BMT for a malignant disease. BMT survivors will be drawn from 5 different BMT centers. A matched comparison sample of 75 survivors of renal transplantation (RT) will also be assessed. BMT patients will complete a telephone interview and a packet of questionnaires at both an initial and 18-month follow-up assessment. RT patients will complete only the packet of questionnaires at both assessments. The overall aims of the proposed research are the (a) identification of the quality of life of adult survivors of BMT across a variety of outcome domains including the physical, social, psychological, and occupational, and (b) identification of patient-, disease-, and treatment-related variables associated with interpatient variability in post-BMT quality of life. Specific aims of the proposed research include (a) comparison of quality of life outcomes in survivors of autologous and allogeneic BMT, (b) examination of the temporal trajectory of post-BMT functional recovery and quality of life, and (c) comparison of post-BMT quality of life with that evidenced by survivors of RT, an analogous medical procedure with previously established and acceptable quality of life outcomes.