Keywords

Cognitive impairment, Fatigue, Frailty, Hematopoietic stem cell transplantation, Quality of life

 

Authors

  1. Mohanraj, Lathika PhD, RN, BMTCN
  2. Sargent, Lana PhD, MSN, RN, FNP-C, GNP-BC
  3. Elswick, R. K. Jr PhD, NREMT-B
  4. Toor, Amir MD
  5. Swift-Scanlan, Theresa PhD, RN, FAAN

Abstract

Background: Hematopoietic stem cell transplant (HSCT) is a potentially curative treatment for hematologic malignancies, with 22 000 HSCTs performed annually in the United States. However, decreased quality of life (QoL) is a frequent and concerning state reported by HSCT recipients.

 

Objectives: We sought to determine if measurements of frailty and cognitive impairment were associated with fatigue and QoL in adult HSCT recipients after autologous HSCT.

 

Methods: Using a longitudinal study design, 32 participants 18 years or older receiving autologous HSCT were recruited from a bone marrow transplant clinic. Each participant completed 2 visits: pre-HSCT and post-HSCT. At each visit, participants completed assessment tools to measure frailty, cognitive impairment, fatigue, and QoL (assesses physical, social/family, emotional, functional, and transplant-related well-being).

 

Results: Participants with increased fatigue scores reported decreased QoL pre- and post-HSCT. Participants with increased frailty showed decreased functional well-being before HSCT and showed correlations with decreased physical, social, and transplant-related well-being post-HSCT. As expected, fatigued participants also showed increased frailty post-HSCT. Participants showed significant changes in physical well-being and fatigue between pre-HSCT and post-HSCT visits.

 

Conclusion: Data analyses from this pilot study show significant correlations between subsets of QoL with fatigue and frailty in autologous HSCT participants pre- and post-HSCT.

 

Implications for Practice: Understanding the impact of frailty on fatigue and QoL in HSCT recipients is critical to assist nurses in initiating educational and behavioral interventions to help mitigate the effects of HSCT.