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Autologous haematopoietic stem cell transplantation and its impact on patient`s quality of life
M. Smilowski, L. Szczechowski, G. Helbig, M. Krawczyk-Kulis, S. Kyrcz-Krzemien Department of Hematology and Bone Marrow Transplantation, Silesian Medical University, Katowice, Poland
Background: Quality of life (QoL) in multiple sclerosis (MS) patients is a very important issue depending on disability status, fatigue and mental health. Autologous haematopoietic stem cell transplantation (AHSCT) which is a therapeutic approach for patients with active relapsing-remitting MS (RRMS) and secondary progressive MS (SPMS) who failed the I- and II- line therapy is considered improving the patient`s QoL.
Objectives: The aim of this study was to evaluate the QoL and fatigue for RRMS/SPMS patients treated with AHSCT in a two-year follow-up as well as to assess the relationship with neurological disability status.
Methods: 57 patients with refractory RRMS (53 patients) and SPMS (4 patients) met the eligibility criteria for AHSCT and completed a 2 year follow-up. All patients were involved to the study according to the guidelines of the European Group for Blood and Marrow Transplantation (EBMT) 2012. The patient`s QoL was evaluated using MSIS-29 and MusiQol questionnaire. The fatigue was evaluated using MFIS. All above mentioned scales are validated for polish population. The disability status was assessed using Expanded Disability Status Scale (EDSS). The examination was performed before AHSCT, and 6, 12 and 24 months thereafter.
Results: The mean MSIS-29 score before AHSCT was 86. In the 6, 12 and 24 months follow-up of AHSCT - the mean score was 78, 66 and 62 respectively. The mean MFIS score before AHSCT was 36 and after treatment it decreased to 28, 24 and 21 after 6, 12 and 24 months respectively. The MusiQoL score before AHSCT was 45, and decreased to 36, 31 and 29after AHSCT. We noticed improvement in EDSS score (from 6.0 before AHSCT to 5.25 after 24 months observation). A positive correlation between EDSS and MSIS-29, MusiQoL and MFIS was observed.
Conclusions: Treatment with AHSCT is a promising option for active RRMS and active SPMS for patients who failed the I- and II- line therapy and has a significant impact on QoL.
M. Smilowski, L. Szczechowski, G. Helbig, M. Krawczyk-Kulis, S. Kyrcz-Krzemien Department of Hematology and Bone Marrow Transplantation, Silesian Medical University, Katowice, Poland
Background: Quality of life (QoL) in multiple sclerosis (MS) patients is a very important issue depending on disability status, fatigue and mental health. Autologous haematopoietic stem cell transplantation (AHSCT) which is a therapeutic approach for patients with active relapsing-remitting MS (RRMS) and secondary progressive MS (SPMS) who failed the I- and II- line therapy is considered improving the patient`s QoL.
Objectives: The aim of this study was to evaluate the QoL and fatigue for RRMS/SPMS patients treated with AHSCT in a two-year follow-up as well as to assess the relationship with neurological disability status.
Methods: 57 patients with refractory RRMS (53 patients) and SPMS (4 patients) met the eligibility criteria for AHSCT and completed a 2 year follow-up. All patients were involved to the study according to the guidelines of the European Group for Blood and Marrow Transplantation (EBMT) 2012. The patient`s QoL was evaluated using MSIS-29 and MusiQol questionnaire. The fatigue was evaluated using MFIS. All above mentioned scales are validated for polish population. The disability status was assessed using Expanded Disability Status Scale (EDSS). The examination was performed before AHSCT, and 6, 12 and 24 months thereafter.
Results: The mean MSIS-29 score before AHSCT was 86. In the 6, 12 and 24 months follow-up of AHSCT - the mean score was 78, 66 and 62 respectively. The mean MFIS score before AHSCT was 36 and after treatment it decreased to 28, 24 and 21 after 6, 12 and 24 months respectively. The MusiQoL score before AHSCT was 45, and decreased to 36, 31 and 29after AHSCT. We noticed improvement in EDSS score (from 6.0 before AHSCT to 5.25 after 24 months observation). A positive correlation between EDSS and MSIS-29, MusiQoL and MFIS was observed.
Conclusions: Treatment with AHSCT is a promising option for active RRMS and active SPMS for patients who failed the I- and II- line therapy and has a significant impact on QoL.
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