Онкогематология (Jul 2014)
Quality of life before autologous stem cells transplantation as prognostic factor in patients with malignant lymphomas
Abstract
Currently high-doses chemotherapy (HD-PCT) + autologous hematopoietic stem cells transplantation (auto-HSCT) is the treatment ofchoice in patients with recurrent and progressive lymphomas. Most of quality of life (QoL) studies in lymphomas patients received HSCT limited on parameters dynamics assessment in the early and late post-transplant period. Aim of this study was to evaluate the QoL parameters and their prognostic significance in lymphoma patients before transplantation. 124 patients with lymphomas (non-Hodgkin lymphomas – 45 patients, Hodgkin's lymphoma – 79 patients) who received HD-PCT + auto-HSCT were included in the study: men – 42.7 % (n = 53), women – 57.3 % (n = 71), median age – 34 years (19–65 years). Patients’ heterogeneity before transplantation regarding quality of life has been revealed. Almost 1/3 of patients showed a significant reduction in the integral index of QoL. Insignificant differences between patients with chemosensitivity and chemoresistant lymphomas regarding QoL before HD-PCT + auto-HSCT were shown. We also analyzed the outcomes of studied patients received HD-PCT + auto-HSCT. With a median follow-up of 18 months, overall survival after transplantation was 72 % (95 % CI 56–84); event-free survival – 64 % (95 % CI 53,3–73,2).Overall and event-free survivals were significantly higher in patients with chemosensitive lymphoma compared with chemoresistance tumor. Differences in the survival rates between patients with no or negligible decrease of QoL integral index and with significant reduction of it also were found. Revealed differences in overall and event-free survival between the groups allowed the first group considered as patients with a favorable prognosis, and the second group – as patients with poor prognosis regarding the transplantation outcome.
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