Health-related Quality of Life in Survivors of Autologous Haematopoietic Stem Cell Transplantation: A Cross-Sectional SF-36 Study from a Tertiary Cancer Centre in India

Abstract

Background: Data on health-related quality of life (HRQoL) of survivors of autologous haematopoietic stem cell transplantation (HSCT) in India are limited. This study describes the HRQoL of autologous HSCT survivors at a tertiary cancer centre in India using the SF-36. Methods: In this single-centre cross-sectional observational study, survivors of autologous HSCT for multiple myeloma (MM) or lymphoma completed the SF-36 through a self-administered Google Form. Scales were scored by the RAND method and converted to norm-based T-scores; physical (PCS) and mental (MCS) component summaries were derived and compared with general-population norms. Associations with routine demographic, clinical and transplant variables from the institutional database were explored with Spearman correlation (Benjamini–Hochberg correction) and multivariable linear regression. Results: Forty-six unique survivors responded (21 MM, 25 lymphoma; 57.5% of 80 eligible); median age was 39 years and median time from transplant 21.8 months. Mean PCS was 50.8 ± 6.1 and MCS 52.4 ± 6.5; only 3 (6.5%) and 1 (2.2%) respondents scored below 40, respectively. Vitality exceeded the population norm (T 59.2; 95% CI 57.8–60.7), whereas social functioning was the only domain below it (T 46.9; 95% CI 45.0–48.8). All respondents rated their health as better than one year earlier. Ceiling effects were marked for role-physical (69.6%) and role-emotional (73.9%). HRQoL did not differ between MM and lymphoma (PCS 49.3 vs 52.1; p = 0.378). None of 12 routine demographic and transplant variables — including age, CD34+ dose, engraftment, mucositis and hospital stay — was associated with PCS or MCS after correction for multiple testing, and multivariable models explained 6% (PCS) and 15% (MCS) of variance. Conclusions: Autologous HSCT survivors attending follow-up reported HRQoL comparable to or above general-population norms, with social functioning the consistent shortfall. Routine transplant variables were not associated with later HRQoL. Ceiling effects, low reliability of two-item scales and survivor selection support prospective, longitudinal measurement with India-specific norms.