Subject(s)
Anemia, Aplastic/therapy , Peripheral Blood Stem Cell Transplantation/methods , T-Lymphocytes/cytology , Transplantation Chimera , Adolescent , Adult , Antigens, CD34/metabolism , Female , Hematopoietic Stem Cell Transplantation , Hematopoietic Stem Cells/cytology , Humans , Male , Middle Aged , Retrospective Studies , Time Factors , Transplantation, Homologous , Treatment Outcome , Young AdultABSTRACT
In total, 124 adult patients in remission after allogeneic hematopoietic SCT (HSCT) participated in a cross-sectional study to assess health-related quality of life (HRQL). Assessment of HRQL was carried out using two questionnaires: the (EORTC QLQ-C30) and the Functional Assessment of Cancer Therapy (FACT) with specific modules for BMT (FACT-BMT). Transplanted patients differed from healthy controls in many HRQL-related dimensions in the EORTC QLQ-C30: social functioning 73.4 versus 85.8, P<0.0001; role functioning 74.6 versus 83.3, P<0.004; physical functioning 83.9 versus 89.9, P<0.001; emotional functioning 72.2 versus 82.8, P<0.0001 but were not significant for global HRQL 71.2 versus 75.3, P<0.03. In total, 60% of the patients returned to work after HSCT; 31% part time and 29% full time. Age at HSCT and employment status were significantly associated with HRQL. Other factors such as disease and disease stage and especially the occurrence of late complications did not impact the perception of HRQL. This study suggests that the perception of HRQL after HSCT differs from the general population. Issues to increase work-related capabilities and improve social support need to be addressed.
Subject(s)
Employment , Hematopoietic Stem Cell Transplantation , Quality of Life , Adult , Age Factors , Aged , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Social Adjustment , Social Support , Survivors , Transplantation, Homologous , Young AdultSubject(s)
Graft vs Host Disease/complications , Hematopoietic Stem Cell Transplantation/adverse effects , Polyradiculopathy/etiology , Adult , Anti-Inflammatory Agents/therapeutic use , Humans , Leukemia, Myeloid, Acute/therapy , Male , Methylprednisolone/therapeutic use , Polyradiculopathy/drug therapyABSTRACT
We report a case of pure red cell aplasia (PRCA) following allogeneic stem cell transplantation (SCT) with major ABO mismatch which proved resistant to all standard treatment options such as change in immunosuppressive treatment, high-dose erythropoietin (EPO) or plasma exchange. We therefore proceeded to administer five cycles of Rituximab therapy, without success. Finally, escalating doses of donor-derived leukocyte infusion (DLI) resolved the PRCA of our patient 415 d after bone-marrow transplantation (BMT) and 140 d after the first infusion of donor leukocytes. A review of the literature shows the efficacy of various treatments; the role of DLI and other treatment options are discussed. Furthermore, the underlying pathophysiological mechanisms especially with regard to the role of NK cells in alloreactivity after allogeneic SCT are explained.
