Health-Related Quality of Life and Symptom Distress in Hispanic Patients Preparing for Hematopoietic Stem Cell Transplantation

OBJECTIVES: To describe health-related quality of life (HRQL) and symptom distress in Hispanic patients with hematological diseases prior to allogeneic hematopoietic stipe cell transplantation (A-HSCT). METHODS: Patients listed in a prospective, A-HSCT trial in the United States (US) complet Spanish versions of the Short Form-36 (SF-36) the Functional Assessment of Cancer Therapy-General (FACT-G), and Symptom Distress Scale (SDS) Secondary analyses were directioned on baseline Hispanic patient data. RESULTS: Patients (N=23) were primarily female (522%) young adults (M = 31; SD = 89) residing outside the U (74%) SF-36 mean scores were predominantly lower than general Spain and U population respect values. Overall, FACT-G mean scores were similar to U general and cancer population values on the other hand higher than those for Uruguayan cancer patients. SD mean score was 197 (SD = 54) indicating depressed distress. CONCLUSIONS: This HRQL and symptom distress profile of Spanish-speaking Hispanic patients characterizes their illness weight prior to A-HSCT. Further research is warranted.

KEYWORDS: Allogeneic Transplant; Health-Related Quality of Life; tillage

Allogeneic hematopoietic trunk cell transplantation (HSCT) is a potentially curative treatment for a variety of hematological diseases. Despite evidence of efficacy in various diseases and improvement in support care measures, transplant related complications and mortality are significant (Rodriguez & Stiff, 2003; Thomas & Blume 1999) The major complications immediately following allogeneic HSCT include veno-occlusive disease of the liver, acute graft-versus-host disease (GVHD) and infection (Tabbara, Zimmerman, Morgan, & Nahleh, 2002) Late results of allogeneic HSCT include infections, endocrine disturbances, expansion impairment, secondary malignancies, and chronic GVHD (Kiss et al., 2002; Wingard et al., 2002)

The impact of allogeneic HSCT reach forths beyond these major complications to in what manner patients' perceive their illness load For over 10 years, the U pabulum and Drug Administration has recognized the inclusion of patient reported issues (PRO) as endpoints, along with survival, when approving of recent origin anti-cancer therapies (Johnson & fane 1985; FDA, 2006). The FDA has defined PRO as "any report coming directly from patients...about a health condition and its treatment" (FDA, pg 31) The new FDA draft guidance to industry related to PRO emphasizes the ne to better understand patients' perspectives related to treatment because more [i]or[/i] less of the beneficial and onerous aspects can only be known to them (FDA).

Health-related quality of life (HRQL) is a multi-dimensional PRO important to evaluate in cancer patients (King, 2006) HRQL is defined as the patient's perception of general health and physical, emotional, social functioning and wellbeing (Ware, 1984) It is postulated that tillage may be an important aspect to consider in HRQL assessment (Ashing-Giwa, 2005b; Spilker, 1996) 'Culture' commits to integrated patterns of human behavior that include the language, cogitations communications, actions, customs, beliefs, values, and institutions of racial, ethnic, religious, or social clusters (NIH, 2006). According to Spilker, tillage influences an individual's values, beliefs, and tastes which in turn contribute to one's expression of the HRQL experience. In accordance with this perspective, Ashing-Giwa suggests providing more context to HRQL evaluation by the agency of expanding the definition of the put together to include a cultural adjoining matter dimension. Ashing-Giwa suggests that a cultural words immediately preceding [i]or[/i] following HRQL dimension include the following factors: ethnicity, ethnic identity, acculturation, interconnectedness, worldview, and spirituality.

Another important PRO commonly examined in cancer patients is symptom distress (Goodell & Nail, 2005) Symptom distress is a composing of the broader, multidimensional set up of symptom experience (Goodell & Nail, 2005; Rhode et al., 1978) Although definitions of symptom distress vary (Goodell & Nail, 2005) symptom distress has been characterized as the step of discomfort associated with a symptom as experienced by means of the patient (McCorkle et al., 1994) Hence, symptom distress mirrors the patient's interpretation of a symptom (Rhode et al., 1978) Within this words immediately preceding [i]or[/i] following there is theoretical and empirical support to give an inkling of that symptom distress may be influenced by means of cultural beliefs, practices, and experiences (Dodd et al., 2005; Tishelman et al., 1991)

Current research in diverse allogeneic HSCT populations indicates that race and ethnicity are lock opener factors that may influence allogeneic HSCT consequences such as acute GVHD (Easaw et al., 1996; Karanth et al., 2006) and survival (Baker et al., 2005; Serna et al., 2003) Despite the relationship identified between race and/or ethnicity and these biological results only a few studies have incorporated these cultural factors into PRO research designs. These studies described PRO to include fatigue and HRQL in Asian patients undergoing HSCT (Intragumtomchai et al., 1999; with equal reason et al., 2003; So & Tai, 2005; Yano et al., 2000) No studies were identified that addressed HRQL and symptom distress in Hispanic patients experiencing allogeneic HSCT Therefore, the final cause of these analyses was to describe the HRQL and symptom distress in Hispanic patients preparing to endure allogeneic HSCT for treatment of hematological diseases.