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Hou SHJ, Stokoe M, Zwicker H, Young-Speirs M, Pelletier W, Guilcher GMT, Khu M, Schulte FSM. Pediatric Hematopoietic Cell Transplantation: A Longitudinal Assessment of Health-Related Quality of Life of Pediatric Donors. J Clin Psychol Med Settings 2023; 30:836-845. [PMID: 36670334 PMCID: PMC9860226 DOI: 10.1007/s10880-022-09933-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/23/2022] [Indexed: 01/22/2023]
Abstract
Pediatric donors may be at increased risk of psychological and social challenges following hematopoietic cell transplantation (HCT). Through a retrospective chart review, we evaluated the health-related quality of life (HRQL) of pediatric donors over time and examined facilitators and barriers to implementing a longitudinal psychosocial assessment. Fifty-one pediatric donors (M = 10.7 years, SD = 3.7) completed an HRQL questionnaire across six time points (T1 to T6) from prior to donation to 2 years after. Change in mean scores was assessed using a linear mixed-effect model for repeated measures design. Facilitators and barriers to implementation were examined. HRQL of pediatric donors improved between T1 and T6 with significant change in physical, emotional, and overall functioning. Facilitators to retention included the support of a clinical coordinator. Barriers to implementation included the absence of infrastructure to maintain contact with pediatric and their families. HRQL of pediatric donors of HCT improved steadily over time. Pattern of results suggests a need to further explore factors that contribute to change across time. Development of a longitudinal standardized assessment protocol that can be prospectively and feasibly implemented is integral to supporting the well-being of this group.
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Affiliation(s)
- Sharon H J Hou
- Division of Psychosocial Oncology, Department of Oncology, Cumming School of Medicine, University of Calgary, 2202 2 St SW, Calgary, AB, T2S 3C3, Canada
- Department of Psychology, British Columbia Children's Hospital, Vancouver, BC, Canada
| | - Mehak Stokoe
- Division of Psychosocial Oncology, Department of Oncology, Cumming School of Medicine, University of Calgary, 2202 2 St SW, Calgary, AB, T2S 3C3, Canada
| | - Hailey Zwicker
- Division of Psychosocial Oncology, Department of Oncology, Cumming School of Medicine, University of Calgary, 2202 2 St SW, Calgary, AB, T2S 3C3, Canada
| | - Morgan Young-Speirs
- Faculty of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Wendy Pelletier
- Hematology, Oncology, Transplant Program, Alberta Children's Hospital, Calgary, AB, Canada
| | - Gregory M T Guilcher
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Melanie Khu
- Hematology, Oncology, Transplant Program, Alberta Children's Hospital, Calgary, AB, Canada
| | - Fiona S M Schulte
- Division of Psychosocial Oncology, Department of Oncology, Cumming School of Medicine, University of Calgary, 2202 2 St SW, Calgary, AB, T2S 3C3, Canada.
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2
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Klippenstein ADW, Piotrowski CC, Winkler J, West CH. Growth in the face of overwhelming pressure: A narrative review of
sibling donor experiences in pediatric hematopoietic stem cell
transplant. J Child Health Care 2023; 27:60-77. [PMID: 34570621 PMCID: PMC9932621 DOI: 10.1177/13674935211043680] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Sibling donation in pediatric hematopoietic stem cell transplant (HSCT) can be emotionally distressing for children, but may simultaneously evoke positive emotions, and has the potential to facilitate personal growth. We conducted a narrative review of sibling donor experiences, which included an analysis of psychosocial distress and post-traumatic growth (PTG). We searched the following databases: MEDLINE, CINAHL, PsycInfo, and SCOPUS. Search concepts used to develop key terms included HSCT, siblings, children, and psychosocial outcomes. Specific inclusion criteria included a) research articles published in English in peer-reviewed journals until September 2020, and b) reported trauma symptoms and PTG characteristics of sibling donation experiences. Four themes were identified: fear and anxiety related to HLA testing, overwhelming pressure to donate, guilt and blame when the ill child died, as well as emotional and physical isolation following donation. Sibling responses also included evidence of PTG, articulated as a deepened appreciation for life, closer relationships with the ill child and other family members, increased personal strength, and spiritual growth. These results highlight a critical need for future research approaches that further empower sibling donor voices, such as those found in participatory, arts-based methodologies.
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Affiliation(s)
- Andrea D Winther Klippenstein
- College of Nursing,
University
of Manitoba, Winnipeg, MB, Canada,Andrea D Winther Klippenstein,
Interdisciplinary Doctoral Student, College of Nursing, Rady Faculty of Health
Sciences, University of Manitoba, 89 Curry Place, Winnipeg, MB R3T 2N2, Canada.
| | - Caroline C Piotrowski
- Department of Community Health
Sciences, University
of Manitoba, Winnipeg, MB, Canada
| | - Janice Winkler
- Elizabeth Dafoe Library,
University
of Manitoba, Winnipeg, MB, Canada
| | - Christina H West
- College of Nursing,
University
of Manitoba, Winnipeg, MB, Canada
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3
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Zhang X, Wang J, Liu Y, Liu J, Wang B, Zhang Q, Guan W, Zhang H, Xu L, Liu G, Zhang P, He Y, Feng S, Han M, Li C, Jiang E, Xie W. Long-term survivors demonstrate superior quality of life after haploidentical stem cell transplantation to matched sibling donor transplantation. J Transl Med 2022; 20:596. [PMID: 36517908 PMCID: PMC9749359 DOI: 10.1186/s12967-022-03803-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 12/01/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND It has been well-documented that haplo-identical hematopoietic stem cell transplantation (HID-HSCT) can provide outcomes comparable to conventional matched sibling donor (MSD) HSCT, however, little is known about the effects on quality of life (QoL) in long-term survivors. This study is to investigate the differences in longitudinal performance of QoL between HID and MSD HSCT using a comprehensive assessment system. METHODS This prospective study enrolled consecutive patients who had received allogenic-HSCT (allo-HSCT) between January 2018 and December 2019 in our center. All patients were informed to complete QoL questionnaires including the Mos 36-Item Short-Form Health Survey (SF-36) and the Functional Assessment of Cancer Therapy Bone Marrow Transplant (FACT-BMT, version 4), using an online applet, before transplantation and at scheduled time points after transplantation. The linear mixed-effects model was used to analyze the variation trend of different dimensions of both SF-36 and FACT-BMT with different follow-up times. RESULTS Of the 425 participants, recipients of HID and MSD who survived more than 1 year (n = 230) were included in the final analysis of QoL (median age [range]: 36, [15, 66]). The 3 year overall survival (OS) of HID and MSD was 82.42% and 86.46%, respectively. QoL was assessed using both SF-36 and FACT-BMT and there was longitudinal recovery with clinical significance in the cohort. Compared to MSD-HSCT patients, HID-HSCT recipients demonstrated superior QoL performance in some subscales describing physical and mental wellness. Specifically, the difference in physical performance is more remarkable using FACT-BMT whereas that in mental wellness is more significant using SF36. In the subsequent stratified analysis, patients with a history of aGVHD or CMV reactivation demonstrated inferior QoL. CONCLUSIONS Long-term survivors of HID HSCT achieved better QoL in some sub-scales compared to MSD HSCT. In addition, SF-36 and FACT-BMT demonstrated different performance thus combination of both improved capacity of the evaluation system.
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Affiliation(s)
- Xiaoyu Zhang
- Department of Hematopoietic Stem Cell Transplantation, State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, 300020, China
| | - Jiao Wang
- Department of Public Health, Tianjin Medical University, 288 Nanjing Road, Tianjin, 300052, China
| | - Yuqiu Liu
- Department of Nursing Care, State Key Laboratory of Experimental Hematology, Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology and Blood Diseases Hospital, National Clinical , Chinese Academy of Medical Sciences and Peking Union Medical College, 288 Nanjing Roa, Tianjin, 300020, China
| | - Jie Liu
- Department of Nursing Care, State Key Laboratory of Experimental Hematology, Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology and Blood Diseases Hospital, National Clinical , Chinese Academy of Medical Sciences and Peking Union Medical College, 288 Nanjing Roa, Tianjin, 300020, China
| | - Bei Wang
- Department of Nursing Care, State Key Laboratory of Experimental Hematology, Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology and Blood Diseases Hospital, National Clinical , Chinese Academy of Medical Sciences and Peking Union Medical College, 288 Nanjing Roa, Tianjin, 300020, China
| | - Qiuhui Zhang
- Department of Nursing Care, State Key Laboratory of Experimental Hematology, Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology and Blood Diseases Hospital, National Clinical , Chinese Academy of Medical Sciences and Peking Union Medical College, 288 Nanjing Roa, Tianjin, 300020, China
| | - Wei Guan
- Department of Nursing Care, State Key Laboratory of Experimental Hematology, Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology and Blood Diseases Hospital, National Clinical , Chinese Academy of Medical Sciences and Peking Union Medical College, 288 Nanjing Roa, Tianjin, 300020, China
| | - Huijuan Zhang
- Department of Nursing Care, State Key Laboratory of Experimental Hematology, Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology and Blood Diseases Hospital, National Clinical , Chinese Academy of Medical Sciences and Peking Union Medical College, 288 Nanjing Roa, Tianjin, 300020, China
| | - Li Xu
- Department of Nursing Care, State Key Laboratory of Experimental Hematology, Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology and Blood Diseases Hospital, National Clinical , Chinese Academy of Medical Sciences and Peking Union Medical College, 288 Nanjing Roa, Tianjin, 300020, China
| | - Guiying Liu
- Department of Nursing Care, State Key Laboratory of Experimental Hematology, Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology and Blood Diseases Hospital, National Clinical , Chinese Academy of Medical Sciences and Peking Union Medical College, 288 Nanjing Roa, Tianjin, 300020, China
| | - Ping Zhang
- Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA, 98109, USA
| | - Yi He
- Department of Hematopoietic Stem Cell Transplantation, State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, 300020, China
| | - Sizhou Feng
- Department of Hematopoietic Stem Cell Transplantation, State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, 300020, China
| | - Mingzhe Han
- Department of Hematopoietic Stem Cell Transplantation, State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, 300020, China
| | - Changping Li
- Department of Public Health, Tianjin Medical University, 288 Nanjing Road, Tianjin, 300052, China
| | - Erlie Jiang
- Department of Hematopoietic Stem Cell Transplantation, State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, 300020, China.
| | - Wenjun Xie
- Department of Nursing Care, State Key Laboratory of Experimental Hematology, Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology and Blood Diseases Hospital, National Clinical , Chinese Academy of Medical Sciences and Peking Union Medical College, 288 Nanjing Roa, Tianjin, 300020, China.
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4
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Worel N, Aljurf M, Anthias C, Buser AS, Cody M, Fechter M, Galeano S, Greinix HT, Kisch AM, Koh MBC, Mengling T, Nicoloso G, Niederwieser D, Pulsipher MA, Seber A, Shaw BE, Stefanski HE, Switzer GE, Szer J, van Walraven SM, Yang H, Halter JP. Suitability of haematopoietic cell donors: updated consensus recommendations from the WBMT standing committee on donor issues. Lancet Haematol 2022; 9:e605-e614. [PMID: 35901845 DOI: 10.1016/s2352-3026(22)00184-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 06/06/2022] [Accepted: 06/07/2022] [Indexed: 06/15/2023]
Abstract
The contribution of related donors to the globally rising number of allogeneic haematopoietic stem cell transplantations (HSCT) remains increasingly important, particularly because of the growing use of haploidentical HSCT. Compared with the strict recommendations on the suitability for unrelated donors, criteria for related donors allow for more discretion and vary between centres. In 2015, the donor outcome committee of the Worldwide Network for Blood and Marrow Transplantation (WBMT) proposed consensus recommendations of suitability criteria for paediatric and adult related donors. This Review provides updates and additions to these recommendations from a panel of experts with global representation, including the WBMT, the European Society for Blood and Marrow Transplantation donor outcome committee, the Center for International Blood and Marrow Transplant Research donor health and safety committee, the US National Marrow Donor Program, and the World Marrow Donor Association, after review of the current literature and guidelines. Sections on the suitability of related donors who would not qualify as unrelated donors have been updated. Sections on communicable diseases, clonal haematopoiesis of indeterminate potential, paediatric aspects including psychological issues, and reporting on serious adverse events have been added. The intention of this Review is to support decision making, with the goal of minimising the medical risk to the donor and protecting the recipient from transmissible diseases.
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Affiliation(s)
- Nina Worel
- Department of Blood Group Serology and Transfusion Medicine, Medical University Vienna, Vienna, 1090, Austria.
| | - Mahmoud Aljurf
- Oncology Center, King Faisal Specialist Hospital & Research Center, Riyadh, Riyadh Province, Saudi Arabia
| | - Chloe Anthias
- Anthony Nolan, London UK; Royal Marsden Hospital, London, UK
| | - Andreas S Buser
- Regional Blood Transfusion Service, Swiss Red Cross, Basel, Switzerland; Hematology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Meghann Cody
- National Marrow Donor Program/Be The Match, Minneapolis, MN, USA
| | - Mirjam Fechter
- Matchis Foundation (the Dutch Centre for Stem Cell Donors), Leiden, the Netherlands
| | | | | | - Annika M Kisch
- Department of Haematology, Oncology, Radiation Physics, Skane University Hospital, Lund, Sweden; Institute of Health Sciences, Lund University, Sweden
| | - Mickey B C Koh
- Infection and Immunity Institute, St George's, University of London, London, UK; Department of Haematology, St George's Hospital, London, UK; Cell Therapy Programme, Health Sciences Authority, Singapore, Singapore
| | | | - Grazia Nicoloso
- Swiss Transfusion Swiss Red Cross, Swiss Blood Stem Cells, Bern, Switzerland
| | - Dietger Niederwieser
- Medical Clinic and Policlinic 1, Haematology, Cellular Therapy and Hemostaseology, Leipzig Medical Centre, University Leipzig, Leipzig, Germany
| | - Michael A Pulsipher
- Division of Pediatric Haematology and Oncology, Intermountain Primary Children's Hospital, Huntsman Cancer Institute at the Spencer Fox Eccles School of Medicine at the University of Utah, Salt Lake City, UT, USA
| | - Adriana Seber
- Hospital Samaritano and Insituto de Oncologia Pediatrica - Graacc-Unifesp, São Paulo, Brazil
| | - Bronwen E Shaw
- Center for International Blood and Marrow Transplant Research (CIBMTR), Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | | | - Galen E Switzer
- Departments of Medicine, Psychiatry, and Clinical and Translational Science, University of Pittsburgh, Pittsburgh, PA, USA
| | - Jeff Szer
- Department of Clinical Haematology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia; The Royal Melbourne Hospital, Melbourne, VIC, Australia
| | - Suzanna M van Walraven
- Department for Quality and Release Management, Sanquin Blood Bank, Amsterdam, Netherlands
| | - Hung Yang
- Australian Bone Marrow Donor Registry, Sydney, NSW, Australia
| | - Jörg P Halter
- Hematology, University Hospital Basel, University of Basel, Basel, Switzerland
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5
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Hong S, L R, Mclellan L, Dabney J, Gerds TA, Rotz S, Kalaycio M, Hanna R, Hamilton BK, Majhail N, Sobecks RM. Comparison of Quality of Life and Outcomes between Haploidentical and Matched Related/Unrelated Donor Allogeneic Hematopoietic Cell Transplantation. Transplant Cell Ther 2022; 28:217.e1-217.e6. [DOI: 10.1016/j.jtct.2022.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 01/04/2022] [Accepted: 01/12/2022] [Indexed: 11/17/2022]
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6
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Cheon J, Lee YJ, Jo JC, Kweon K, Koh S, Min YJ, Park SH, Lee SH, Kim HJ, Choi Y. Late complications and quality of life assessment for survivors receiving allogeneic hematopoietic stem cell transplantation. Support Care Cancer 2020; 29:975-986. [PMID: 32556712 DOI: 10.1007/s00520-020-05572-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Accepted: 06/11/2020] [Indexed: 01/20/2023]
Abstract
PURPOSE 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. METHODS 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. RESULTS 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. CONCLUSION 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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Affiliation(s)
- Jaekyung Cheon
- Department of Hematology and Oncology, Ulsan University Hospital, University of Ulsan College of Medicine, 877, Bangeojinsunhwandoro, Dong-gu, Ulsan, 44033, South Korea
| | - Yoo Jin Lee
- Department of Hematology and Oncology, Ulsan University Hospital, University of Ulsan College of Medicine, 877, Bangeojinsunhwandoro, Dong-gu, Ulsan, 44033, South Korea
| | - Jae-Cheol Jo
- Department of Hematology and Oncology, Ulsan University Hospital, University of Ulsan College of Medicine, 877, Bangeojinsunhwandoro, Dong-gu, Ulsan, 44033, South Korea
| | - Kukju Kweon
- Department of Psychiatry, Ulsan University Hospital, University of Ulsan College of Medicine, 877, Bangeojinsunhwandoro, Dong-gu, Ulsan, 44033, South Korea
| | - SuJin Koh
- Department of Hematology and Oncology, Ulsan University Hospital, University of Ulsan College of Medicine, 877, Bangeojinsunhwandoro, Dong-gu, Ulsan, 44033, South Korea
| | - Young Ju Min
- Department of Hematology and Oncology, Ulsan University Hospital, University of Ulsan College of Medicine, 877, Bangeojinsunhwandoro, Dong-gu, Ulsan, 44033, South Korea
| | - Sang-Hyuk Park
- Department of Laboratory Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, 877, Bangeojinsunhwandoro, Dong-gu, Ulsan, 44033, South Korea
| | - Sin-Hye Lee
- Department of Hematology and Oncology, Ulsan University Hospital, University of Ulsan College of Medicine, 877, Bangeojinsunhwandoro, Dong-gu, Ulsan, 44033, South Korea
| | - Hyo-Jin Kim
- Department of Hematology and Oncology, Ulsan University Hospital, University of Ulsan College of Medicine, 877, Bangeojinsunhwandoro, Dong-gu, Ulsan, 44033, South Korea
| | - Yunsuk Choi
- Department of Hematology and Oncology, Ulsan University Hospital, University of Ulsan College of Medicine, 877, Bangeojinsunhwandoro, Dong-gu, Ulsan, 44033, South Korea.
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7
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Xie W, Zhang X, Wang J, Zhang J, Liu J, Wang B, Guan W, Zhang H, Xu L, Liu G, Feng S, Li C, Han M. Evaluation of quality of life and its influencing factors after transplantation of leukemia patients based on SF-36 score: a cohort study. Qual Life Res 2020; 29:1809-1816. [DOI: 10.1007/s11136-020-02444-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/08/2020] [Indexed: 10/24/2022]
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