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      Symptom Burden Remains Significant for Bone Marrow Transplant Patients After Hospital Discharge: Presented at ASH

      By Bruce Sylvester

      ATLANTA, GA -- December 12, 2005 -- Many bone marrow recipients still carry significant symptom burden 30 days after being discharged from the hospital, requiring additional assistance with their daily functioning, researchers stated here at the 47th Annual Meeting of the American Society of Hematology (ASH).

      Although numerous studies examined toxicities related to bone marrow transplantation, few studies have looked at patient reports of symptom burden in the days and weeks following transplantation.

      Loretta A. Williams, DSN, instructor, department of symptom research, the University of Texas, MD Anderson Cancer Center, Houston, Texas, presented the findings on December 11th.

      "Some of the most important take-home points are that although patients at 30 days after a transplant have been discharged from the hospital and some of their symptoms have resolved, many of their other symptoms that significantly impact their well being and their ability to function -- such as fatigue, lack of appetite, and physical weakness -- are not anywhere nearly recovered by 30 days posttransplant," Dr. Williams explained.

      The researchers conducted a retrospective analysis of information on 30 patients with a mean age of 52.9 years. They asked patients to rate 19 of their symptoms on a scale of 0 to 10 twice weekly for 28 days following bone marrow transplant. Patients utilized the MD Anderson Symptom Inventory to record their results.

      Results show that the mean global symptom intensity peaked at day 11 posttransplant. The seven most severe symptoms after the 11th day were pain, drowsiness, lack of appetite, dry mouth, mouth sores, physical weakness, and fatigue.

      Although mean pain scores and mouth scores declined significantly from day 11, there was no significant difference in the mean global symptom index on day 11 and day 29.

      Following bone marrow engraftment, patients reported that pain intensity declined rapidly. However, investigators noted that gastrointestinal symptoms declined more slowly, and fatigue and weakness did not decline at all.

      "I think that tells us that just because we get [patients] out of the hospital they probably are not completely recovered and they are still going to need a significant amount of assistance with their daily functioning," Dr. Williams said.


      [Presentation title: Assessment of Symptoms and Symptom Burden Before and After Engraftment During Allogeneic Blood or Marrow Transplant (BMT). Session Type: Poster Session 481-I. Abstract 1323]



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