July 22, 2004
Full recovery from bone marrow or stem cell transplants may take years
Patients with leukemia or lymphoma who receive bone marrow or stem cell transplants and survive can expect that it will be three to five years before they fully recover, according to a study published in the May 19 issue of the Journal of the American Medical Association.
Dr. Karen Syrjala, associate professor of psychiatry and behavioral sciences at the UW and a researcher at Fred Hutchinson Cancer Research Center, and her colleagues examined the recovery of patients who had bone marrow or stem cell transplants after bone marrow suppression. They looked at mental health as well as physical health, and at how soon patients returned to work.
The study followed 319 adults. Of the 99 long-term survivors with no recurrent malignancies, 94 completed the study.
One year after transplant, only 19 percent of the patients had recovered on all the outcomes measured — physical, psychological and work recovery. After five years, 63 percent did not have major limitations. Given enough time, 84 percent of the survivors returned to full-time work.
The study also found that some factors measured before the transplants could help predict recovery: higher levels of depression, lower levels of physical function and less satisfaction with social support were related to delayed recovery after the procedures.
In their conclusion, the researchers noted: “These results are both encouraging and cautionary. Patients, families, and medical teams depend on accurate recovery data when planning for posttransplant needs. Expectations that contradict actual experience cause stress for survivors and potential conflicts with family, work, and the medical team. To facilitate realistic planning, clinicians and patients should understand that full recovery requires more than a year for most survivors. Patients at risk for delayed recovery can be identified before transplantation. Rehabilitation programs, similar to those that have accelerated recovery for cardiac patients, might improve the physical and psychological health of [bone marrow and stem cell transplant] recipients and other patients who have survived after curative treatment for cancer.”