Comparison Of Health-related Quality Of Life After Single-unit Unrelated Cord Blood Transplantation Or HLA-matched Sibling Donor Stem Cell Transplantation:A Prospective,Non-randomized Clinical Trial

Purpose To compare the health-related quality of life(HRQOL)of patients with hematological malignancies aged 14 years or older after cord blood transplantation and HLA-matched allogeneic hematopoietic stem cell transplantation,and to analyze the influencing factors,so as to provide guidance for follow-up and intervention of patients after transplantation.Methods Prospectively investigate HRQOL of 14-year-old and older patients with hematological malignancies who underwent UCBT and HLA-matched sibling donor stem cell transplantation in Anhui Provincial Hospital from February 2018 to January2019.Two scales,SF-36 and FACT-BMT,were used to conduct questionnaires before transplantation,and on day+7,day+30,day+90 and day+180 after transplantation.Among them,SF-36 includes physiological function,physiological function,physical pain,general health status,energy,social function,emotional function,and mental health 8 domains.The survey items of FACT-BMT scale include five dimensions:physical condition,social/family condition,emotional status,functional status and transplantation-related status.They are composed of 50 items,each item scored 0-4points.This study conforms to the ethical standards formulated by the China Registered Clinical Trial Ethics Committee.It was approved by the Committee,obtained the registration number of clinical trials(ChiCTR1800014653),obtained the informed consent of the subjects,and signed the informed consent for the clinical research.Results Ninety-two cases of umbilical cord blood group and nineteen cases of sibling group were included in this study.The median ages were 30 years and 33 years,respectively.There was no significant difference in age,weight,diagnosis,disease status,conditioning regimens and the incidence of acute graft-versus-host-disease between the two groups,but there were more male patients in cord blood group(64%vs21%,P=0.000),and more incidence of pre-engraftment syndrome.What's more,in the sibling group,there are higher HLA compatibility,higher blood type compatibility,more infused total nuclear cells and CD34~+cells(P<0.05).Overall HRQOL curves of the two groups showed a downward trend and then an upward trend over time.The lowest score was on day+7 after cord blood transplantation and on day+30 after HLA matched allogeneic hematopoietic stem cell transplantation.Univariate and multivariate analysis showed that patients underwent cord blood transplantation had better social function scores(P<0.05).Furthermore,gender and disease status were independent influencing factors for HRQOL change after HSCT(P<0.05).The scores of health status of each module of FACT-BMT in females before transplantation were lower than those in males.Conclusion HRQOL was the worst on day+7 and day+30 separately after CBT and HLA-matched SDT.Medical staff should strengthen management and take appropriate interventions to minimize the physical and mental pain of transplanted patients.Female patients and patients who had relapsed before have a worse HRQOL after stem cell transplantation.This difference may be more obvious with the prolongation of follow-up time.Long-term follow-up is still needed.