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Qol and Patients' Care

Health-related quality of life in pediatric patients after allogeneic SCT: development of the PedsQL Stem Cell Transplant module and results of a pilot study

Bone Marrow Transplantation volume 49, pages 1093–1097 (2014)Cite this article

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Abstract

With increased survival after pediatric allogeneic hematopoietic SCT health-related quality of life (HRQL) has emerged as an essential health outcome. The impact of transplant and chronic GVHD (cGVHD)-associated morbidity remains a major obstacle. In 2005, the National Institutes of Health (NIH) Consensus Conference on Criteria for Clinical Trials in cGVHD recommended HRQL tools as an independent measure of the impact of disease burden. The NIH recommendations did not provide a cGVHD-specific tool for HRQOL measures in children. This report focuses on the development of an SCT-specific instrument to assess HRQL in children and adolescents. For the assessment of generic HRQL we chose the PedsQL (Pediatric Quality of Life Inventory) Generic Cores Scales, which have been used in a large number of healthy, acutely ill and chronically ill children and adolescents. To capture SCT- and, specifically, cGVHD-related problems, we developed the PedsQL Stem Cell Transplant module by reviewing the literature, taking over some items/scales of other PedsQL modules, interviewing patients, parents and members of the health-care team, and applying the PedsQL measurement methods. The final PedsQL Stem Cell Transplant module consists of the HRQL domains: pain and hurt, fatigue/sleeping problems/weakness, nausea, worry/anxiety about disease/treatment, nutritional problems, neurocognitive problems, communication about disease/treatment, loneliness, physical functioning and additional somatic complaints (pruritus, skin inflammation, oral problems, eyes or breathing) including patients’ and parents’ assessment. It was tested in 35 pediatric patients, who were referred to our SCT Outpatient Clinic about 100 days post SCT. Both the generic PedsQL and the SCT-specific scales showed high internal consistency, with Cronbach alpha levels of ⩾0.70 in almost all scales. Most problems were detected within the HRQL domains of physical functioning and pain. The summary scores of the generic PedsQL and the PedsQL Stem Cell Transplant module showed high correlations (r=0.89 in patients’ and r=0.81 in parents’ assessments). Moreover, both tools discriminated between patients with and without cGVHD. The PedsQL Stem Cell Transplant module is practical for use and suitable across a broad age range (2–18 years) both in patients with and without cGVHD. However, it is still a pilot instrument and needs further development and testing in a larger patient population.

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Acknowledgements

This study was supported by a grant from Fonds der Stadt Wien für Innovative Interdisziplinäre Krebsforschung, Vienna, Austria

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Authors and Affiliations

  1. St Anna Children’s Hospital, SCT-Unit, Medical University Vienna, Vienna, Austria

    A Lawitschka, E D Güclü, M Putz, C Peters & R Felder-Puig

  2. Colleges of Architecture and Medicine, Texas A&M University, College Station, TX, USA

    J W Varni

  3. Department of Medicine III, University Hospital Regensburg, Regensburg, Germany

    D Wolff

  4. National Cancer Institute, National Institutes of Health, Bethesda, MD, USA

    S Pavletic

  5. Department of Internal Medicine I, BMT, Medical University of Vienna, Vienna, Austria

    H Greinix

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  1. A Lawitschka
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Correspondence to A Lawitschka.

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Lawitschka, A., Güclü, E., Varni, J. et al. Health-related quality of life in pediatric patients after allogeneic SCT: development of the PedsQL Stem Cell Transplant module and results of a pilot study. Bone Marrow Transplant 49, 1093–1097 (2014). https://doi.org/10.1038/bmt.2014.96

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