Assessment of quality of life during intensive chemotherapy or bone marrow transplantation

Quality of life (QOL) of 179 patients with hematological malignancies, hospitalized for induction chemotherapy, allogeneic or autologous bone marrow transplantation (BMT), was analyzed on three time points at 10 days interval after completion of the cytotoxic treatment. The instruments used were the EORTC questionnaire--with modifications of the physical and social functioning subscales, in order to adapt to the prolonged stay in the hospital--, the Hospital Anxiety and Depression Scale, and a specifically designed leukemia/BMT module. The psychometric properties of the scales were confirmed, except for the physical functioning and social subscales, for which further methodological studies are warranted. A relatively high frequency of somatic symptoms, fatigue, anxiety and depression was observed, with a trend to improvement at the end of hospitalization. The overall self-assessed QOL correlated mainly with fatigue and emotional disorders but not with the somatic symptoms. Randomized disclosure of the collected information to the staff allowed them to better identify patients who needed a psychotherapeutic intervention, but did not influence the psychological and QOL outcomes.