Andrykowski et al identified factors affecting the quality of life (QOL) following a bone marrow transplantation for a hematologic malignancy. These can help identify a patient who may benefit from closer monitoring. The authors are from multiple university medical centers in the United States.


In general patients who have had bone marrow transplant report a poorer quality of life compared to before the transplant and to age-matched controls.


Patient selection: > 18 years old and in complete remission


Factors associated with a poorer quality of life.

(1) older age at the time of transplant (limits not specified; will use >= 55 years of age in the implementation)

(2) lower levels of education (high school or less)

(3) more advanced disease at the time of the transplant (correlating with the need for more cytotoxic therapy)

(4) short time since the transplant (QOL tends to improve over time)

(5) moderate to severe graft vs host disease (GVHD; suggesting some degree of incompatibility in the match)

(6) allogeneic transplant


Qualities of life most often affected:

(1) fatigue

(2) occupational, especially if vigorous exertion required (imposes a significant economic burden)

(3) sleep quality

(4) sexual relationships and function, especially in women

(5) concerns about attractiveness (if chronic GVHD develops)

(6) cognitive impairment

(7) physical symptoms (nausea, skin itch, mouth sores, blurred vision), especially if allogeneic transplant (suggesting GVHD)


To read more or access our algorithms and calculators, please log in or register.