Late complications and quality of life assessment for survivors receiving allogeneic hematopoietic stem cell transplantation



The survival rates of patients undergoing allogeneic hematopoietic stem cell transplantation (HSCT) have improved. However, HSCT can induce significant long-term complications. Therefore, we investigated the late complications and risk factors for quality of life (QOL) post-HSCT.


We retrospectively analyzed 67 adult survivors over 2 years after HSCT between 2015 and 2018 at Ulsan University Hospital, Ulsan, Korea. The survey data including FACT-BMT, Hospital Anxiety and Depression Scale, and NCCN Distress Thermometer were collected as patient-reported outcomes using a tablet PC during a routine practice of survivorship clinic.


The median age was 46 years. The most common symptom was fatigue (80.6%). Younger age (< 60 years), acute lymphoblastic leukemia (ALL), chronic graft-versus-host disease (GVHD), and immunosuppressant use were significantly associated with worse QOL and depression. Additionally, younger survivors (< 60 years) showed significantly more fatigue and anxiety compared with elderly survivors (≥ 60 years). Female sex was significantly associated with lower physical well-being and higher distress than male sex.


Younger patients (< 60 years), female, ALL, chronic GVHD, and continuous immunosuppressant use were significant risk factors for worse QOL and depression. Hence, creating a more active survivorship care plan after HSCT, specifically for these patients, is required.

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Fig. 1



Allogeneic hematopoietic stem cell transplantation


Graft-versus-host disease


Quality of life


Functional Assessment of Cancer Therapy-Bone Marrow Transplantation


Bone Marrow Transplantation Subscale


Physical well-being


Social/family well-being


Emotional well-being


Functional well-being


Hospital Anxiety and Depression Scale






National Comprehensive Cancer Network’s Distress Thermometer


Brief Pain Inventory


Acute myeloid leukemia


Acute lymphoblastic leukemia


Aplastic anemia


Myelodysplastic syndrome


Reduced intensity conditioning


Myeloablative conditioning


Anti-thymocyte globulin


Total Outcome Index


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This work was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education, Science and Technology (NRF-2017R1C1B5015107), and it was also supported by the Ulsan University Hospital Research Grant (UUH-2019-06).

Author information




Yunsuk Choi, Jaekyoung Cheon, Jae-Cheol Jo, SuJin Koh, and Young Ju Min contributed to the study conception and design. Patient management and data collection were performed by Jaekyoung Cheon, Yoo Jin Lee, Jae-Cheol Jo, Kukju Kweon, Sang-Hyuk Park, Sin-hye Lee, and Hyo-jin Kim. Data analysis was performed by Yunsuk Choi and Jaekyoung Cheon. The first draft of the manuscript was written by Yunsuk Choi and Jaekyoung Cheon. All authors reviewed the manuscript and contributed to the editing of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Yunsuk Choi.

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Cheon, J., Lee, Y.J., Jo, J. et al. Late complications and quality of life assessment for survivors receiving allogeneic hematopoietic stem cell transplantation. Support Care Cancer (2020).

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  • Allogeneic hematopoietic cell transplantation
  • Late complications
  • Quality of life
  • Fatigue
  • Hospital Anxiety and Depression Scale