Background Autologous HSCT, the object of this study, is characterized by the fact that the donor is the patient himself, who has his cells extracted and cryopreserved before the transplant procedure. Autologous HSCT appears in this scenario as a promising therapeutic alternative for Systemic sclerosis (SSc). Because it is an innovative therapy in the treatment of SSc, there is urgent need for studies that can assess not only the effectiveness of the technique, but also its impact on patients' lives.
Objectives The goal of our study was to evaluate the impact of HSCT on the Quality of Life (QoL) of SSc patients, before and one-two years after the procedure.
Methods This is a descriptive and exploratory study, with longitudinal cross-section. The sample consisted of 22 patients, treated at a University Hospital in the state of São Paulo, Brazil. The MOS SF-36 scale, used for data collection, consists of 36 items that assess two main components: the physical health component (PHC) and the mental health component (MHC). The PHC encompasses the following domains: physical functioning (PF), role limitations due to physical problems (RP), bodily pain (BP) and general health perceptions (GH). The MHC comprises: vitality (VT), social functioning (SF), role limitations due to emotional problems (RE) and general mental health (MH). The results of each domain range from 0 to 100, where zero represents the worst and 100 the best state of health. Data were collected at admission and 1-2 years after transplantation. The instruments were applied individually. Results were subjected to statistical analyses. Significance levels used were p≤0.05.
Results Before HSCT: PF: mean (x)=41.3, SD=33.9; RP: x=23.8, SD=40.4; BP: x=46.8, SD=32.9; GH: x=52.2, SD=27.0; VT: x=55.2, SD=30.1; SF: x=63.0, SD=26.2, RE: x=54.5, SD=45.4; MH: x=59.4, SD=24.5. After HSCT: PF: mean (x)=67.2, SD=28.4; RP: x=42.3, SD=30.0; BP: x=71.1, SD=25.9; GH: x=66.6, SD=14.3; VT: x=67.2, SD=20.3; SF: x=68.5, SD=27.6, RE: x=54.5, SD: 41.8; MH: x=64.6, SD: 23.8. While RE values remained stable after HSCT, others have increased significantly, with p=0.01 (PF, RP, BP, VT, SF, MH) p=0.05 (GH).
Conclusions Our results indicate an improvement in the components of QoL of patients with SSc after HSCT. The positive perception of QoL in the late post-transplantation period may be related to the fact that patients may not face the constant possibility of disease progression, translated by stabilization or improvement after the procedure. These results may be interpreted as positive outcomes of the HSCT for SSc.
Burt, R.K et al. Autologous HSCT for systemic sclerosis. Lancet, v.381, p.2080-2081, 2013.
Guimarães, F.A.B et al. Quality of life of patients with autoimmune diseases submitted to bone marrow transplantation. Rev. Latino-Am. Enfermagem, v.16, n.5, p.856-863, 2008.
Acknowledgements FAPESP; CNPq
Disclosure of Interest None declared
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