Motor ability, function, and health-related quality of life as correlates of symptom burden in patients with sclerotic chronic graft-versus-host disease receiving imatinib mesylate

Abstract

Purpose

To explore improvement in motor ability, function, health-related quality of life (HRQOL), and symptom severity in patients with sclerotic chronic graft-versus-host disease (ScGVHD) in response to treatment as well as the relationship among changes on such measures.

Methods

This study was a secondary analysis of data from 13 individuals with severe ScGVHD enrolled in a clinical trial evaluating the efficacy of imatinib mesylate (clinicaltrials.gov identifier: NCT00702689). Self-reported, clinician-reported, and performance-based indicators of motor ability, function, HRQOL, and symptom severity were assessed at baseline and 6 months following the administration of imatinib mesylate.

Results

Participants did not show statistically significant improvement on any measures over time. Approximately one-third of patients displayed clinically significant improvement on measures of motor ability (palmar pinch strength, dominant hand, 30.8%), functioning (Manual Ability Measure—36, 41.7%), HRQOL (Short Form 36 [SF-36] Mental Component Summary, 33.3%), and symptom severity (Lee Symptom Scale, 38.5%). Improvement in cGVHD symptom burden was correlated with improvement in function (Assessment of Motor and Process Skills [AMPS] and Disabilities of the Arm, Shoulder, and Hand [DASH] scores) and HRQOL (SF-36 Physical Component Summary scores).

Conclusions

Findings suggest the potential utility of administering patient-reported and performance-based functional measures, such as the DASH and the AMPS, to patients with cGVHD. By understanding the functional consequences of ScGVHD, interdisciplinary teams of health care providers, including rehabilitation professionals, can work to improve long-term outcomes.

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Acknowledgments

We thank the patients who participated in this study for their contributions to our growing understanding of sclerotic chronic graft-versus-host disease. We also thank the NIH Chronic GVHD Multidisciplinary Team, the research nurses, Christiana Booher, and Bonnie Hodsdon for their respective contributions to this project. We thank the NIH Fellows Editorial Board for their editorial assistance.

Funding

This research was supported by the National Institutes of Health Intramural Research Programs and the National Cancer Institute’s NCT00702689.

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Correspondence to Leora E. Comis.

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The protocol was approved by the National Cancer Institute Institutional Review Board.

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Rosenthal, E.A., Ho, P., Joe, G.O. et al. Motor ability, function, and health-related quality of life as correlates of symptom burden in patients with sclerotic chronic graft-versus-host disease receiving imatinib mesylate. Support Care Cancer 28, 3679–3689 (2020). https://doi.org/10.1007/s00520-019-05207-z

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Keywords

  • Chronic graft-versus-host disease
  • Sclerosis
  • Functional impairment
  • Symptom burden
  • Health-related quality of life
  • Allogeneic hematopoietic stem cell transplantation