| Autor: |
Wolff, Daniel, Herzberg, Philipp Y., Herrmann, Anne, Pavletic, Steven Z., Heussner, Pia, Mumm, Friederike, Höfer, Christina, Hilgendorf, Inken, Hemmati, Philipp G., Holler, Ernst, Greinix, Hildegard, Mitchell, Sandra A. |
| Zdroj: |
Bone Marrow Transplantation; January 2021, Vol. 56 Issue: 1 p243-256, 14p |
| Abstrakt: |
Comorbidity after allogeneic hematopoietic stem cell transplantation (alloHSCT) impairs quality of life (QoL), physical functioning, and survival. We developed a new standardized measure to capture comorbidity after transplantation, the Post-transplant Multimorbidity Index (PTMI) in a cohort of 50 long term survivors. We subsequently evaluated the content validity and impact on survival and QoL within a multicenter trial, including 208 patients (pts) after alloHSCT, who were prospectively evaluated applying the FACT-BMT, the Human Activity Profile (HAP), the SF-36 v.2, PTMI and the Hematopoietic Cell Transplantation-Comorbidity Index (HCT-CI). The most prevalent comorbidities were compensated arterial hypertension (28.4%), ambulatory infections (25.5%), iron overload (23%), mild renal function impairment (20%), and osteoporosis (13%). Applying the PTMI 13% of patients had no comorbidity, while 37.1% had 1–3 comorbidities, 27.4% had 4–6 comorbidities, and 13.5% had > 6 comorbidities. Chronic graft-versus-host disease (cGvHD) was significantly associated with the PTMI, while age and prior acute GvHD were not. In contrast, the HCT-CI was not associated with the presence of cGvHD. cGvHD was significantly associated with depression (r= 0.16), neurological disease (r= 0.21), osteoporosis (r= 0.18) and nonmelanoma skin cancer (r= 0.26). The PTMI demonstrated strong measurement properties and compared to the HCT-CI captured a wider range of comorbidities associated with cGvHD. |
| Databáze: |
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