Calidad de vida relacionada con la salud en pacientes con Leucemia sometidos a Trasplante de Célula Pluripotencial Hematopoyético Alogénico

Antecedentes: Actualmente no se conoce suficientemente la calidad de vida relacionada con la salud (CVRS) en pacientes sometidos a trasplante de células pluripotencial hematopoyéticas , aunque se utilice ampliamente para el tratamiento de leucemias. Objetivo: Estudiar la CVRS de los pacientes que fueron tratados con trasplante de células hematopoyéticas totipotenciales con diagnostico de leucemia. Material y métodos: Se analizaron 35 pacientes entre 18 y 62 años de edad con diagnostico de leucemia, aguda y crónica que fueron tratados con trasplante de células pluripotencial hematopoyéticas alogénico. Así mismo, un grupo control de 35 pacientes agrupados por edad y sexo sin alguna enfermedad diagnosticada. A los 70 sujetos se les aplicó mediante encuesta el instrumento SF 36 V.2, el cual consta de ocho dominios, comparándose las puntuaciones. Resultados: Se encontró que el grupo control tiene mejor calidad de vida en los siguientes dominios: función física con una calidad de 93% (p=.259), rol físico de 91% (p=0.441), función social 80% (p=0.144), y dolor corporal 82% (p=0.338); en cuanto a los pacientes post trasplantados tuvieron mejor CVRS en los dominios correspondientes a salud general 71% (p=0.473), vitalidad 73% (p=0.469), y salud mental 82% (p=0.458). Ambos grupos tuvieron los mismos resultados para rol emocional 86%(p=1.00). Además, se observo que los pacientes con EICH aguda y leucemia linfocítica crónica tienen mejor CVRS. Discusión: Los pacientes sometidos a TCH obtuvieron mejor CVRS en el resumen del componente mental (incluye SM, RE, FS, V) que el grupo control, esto se debe a que existen grandes cambios en la vida de una persona cuando son diagnosticados con un padecimiento que sin tratamiento pueda resultar en la muerte. Conclusiones: Los pacientes que son expuestos a este método de tratamiento tienen algunas aspectos de CVRS mejor que el grupo control. Hace falta hacer estudios con una mayor población para colaborar a estos datos. ABSTRACT Background: The health related quality of life (HRQL) in patients treated with a stem cell transplant (SCT) is unknown, even though this method is used continuously to treat leukemias. Aim: To analyze the HRQL in patients that have been diagnosed with leukemia and been treated with a low intensity stem cell transplant. Methods: 35 patients between the ages of 18 and 62 years old with diagnosed leukemia, either acute or chronic, that receive an allogeneic stem cell transplant. And a control group of 35 patients paired up by age and sex, which do not have a diagnosed disorder. 70 of these subjects took SF 36 v2 questionnaire, which describes 8 domains to evaluate quality of life. The results were compared. Results: Our study demonstrated that the control group had better HRQL in the following domains: Physical function with a score of 93% (p=0.259), physical role of 91% (p=0.441), social function 80% (p=0.144), and corporal pain 82% (p=0.338), patients that received stem cell transplant had better quality of life in general health 71% (p=0.473), vitality 73% (p=0.469) and in mental health 86% (p=0.458). Both groups had the same result for emotional role 86% (p=1.00). Also, we observed that patients with acute GCHD, and with diagnosis of chronic lymphocytic leukemia had very HRQL. Discussion: Patients that undergo SCT have better HRQL with regards to the mental summary component (including MH, RE, SF, V), than the control group because big changes occur in a persons life when they are diagnosed with a disease that without treatment can be lethal. Conclusions: The patients that underwent this treatment have some aspect of their HRQL higher than those in our control group. However, more studies are needed on a bigger population to conclude this data

Health-Related Quality of Life in leukemia Survivors of Allogeneic Hematopoietic Stem Cell Transplantation Employing the Mexican Reduced-Intensity Conditioning

Background: Quality of life (QOL) is an important consideration in the counseling, implementation, and post-treatment management of arduous treatments for life-threatening conditions such as allogeneic hematopoietic cell transplantation (allo-HCT). Objective: To analyze the QOL of leukemia patients allografted with the Mexican reduced-intensity conditioning regimen in two Mexican academic medical centers. Material and methods: By means of the quality metric short form 36 version 2 to measure generic health concepts, relevant QOL was analyzed in leukemia patients who underwent allo-HCT using reducedintensity conditioning on an outpatient basis at either the Centro de Hematología y Medicina Interna de Puebla of the Clínica Ruiz or the Hematology Service of the Internal Medicine Department of the Hospital “Dr. José Eleuterio González” of the Universidad Autónoma de Nuevo León, and who had survived more than 12 months after the allograft, who could be approached, who were in a continued complete remission (with or without graft-versus-host disease), and who were willing to respond to the questionnaire. Thirty-five patients fulfilling these requirements were included, and a sex- and age-matched group of 35 reference subjects was also studied. Results: Allografted patients were found to have a slightly better mental component summary than the reference subjects (53.23 vs. 48.66 points; p = 0.01), whereas the physical component summary did not show a difference (54.53 vs. 52.05 points; p = 0.59). Most of the differences between allografted individuals and reference subject controls were not significant. Conclusions: Despite several sources of bias, these data suggest that allografted individuals employing the Mexican reduced-intensity conditioning regimen enjoy a health-related QOL life similar to that of reference subjects, adding another advantage of this method of conducting stem cell allografts. However, more work needs to be done to elucidate the impact of reduced-intensity conditioning on post allo-HCT QOL. (REV INVES CLIN. 2015;67:109-16) Corresponding author: Guillermo J. Ruiz-Argüelles, [email protected]