Table 1.
Observational Studies of Sleep in Hematopoietic Cell Transplant Recipients
| Study | Sample | Demographics | Time Frame | Sleep Measures |
Statistical Analyses |
Main Relevant Findings |
|---|---|---|---|---|---|---|
| Anderson et al. (2007) (31) |
Auto HCT (N=100) Included both disease free & relapsed patients NHL (34%), MM (66%) |
Age: Mean = 53.6 (9.7) Range = 24-75 Gender: M = 60% F = 40% Race: Caucasian = 81% African American = 12% Hispanic = 5% Other = 2% |
Longitudinal; 5 assessments: Pre-HCT, 3rd-4th day of conditioning, day 0, nadir, day 30) |
MDASI-BMT (a single item measure of sleep disruption) |
Repeated Measures ANOVA |
The percentage of patients reporting disturbed sleep at moderate or severe levels at each time point were as follows: 8% at baseline, 34% at conditioning, 39% at nadir, 14% at day 30. 8 % reported sleep disruption at baseline, 34% at conditioning, 26% at transplant, 39% at nadir and14% at day 30. Sleep disruption was one of most severe symptoms at nadir, returned to pre-HCT levels by day 30 post-HCT Sleep disruption was significantly worse for NHL than MM patients (p=.024) |
| Andrykowski et al. (2005) (48) |
HCT survivors (N=662) & age- and sex- matched healthy controls (N=158) Allo (41%), Auto (59%), Missing (1%) AML (29%), CML (19%), ALL (7%), Breast cancer (23%), Lymphoma (20%), Other (1%) |
Mean Age: 50.1 (14.2) Gender: M = 30% Race: White = 95% |
Cross-sectional; Mean of 7 years (84 months) post-HCT (inclusion criteria: >12mo post-HCT) |
MOS-Sleep | MANOVA (univariate analyses) |
HCT survivor group reported more sleep problems than healthy control group (effect size = .39, p<.001). |
| Bevans et al. (2008) (3) |
Allo HCT (N=76) RIC (54%), Myeloablative (46%) Included patients in remission and with progressive disease Acute leukemia (17%), Chronic leukemia (38%), Lymphoma or MM (29%), MDS (12%), Non-hematological malignancy (4%) |
Mean Age: 40.2 (13.5) Gender: M: = 67% F: = 33% Race: Caucasian = 46% Hispanic = 30% Asian = 9% Black = 7% Other = 8% |
Longitudinal; Baseline (before transplant conditioning), Day 0, Day 30, Day 100 |
Symptom Distress Scale |
Univariate descriptive analyses |
At baseline, approximately 55% of patients reported insomnia, 86% had insomnia at day 0, nearly 70 % had insomnia at day 30 and at day 100, insomnia levels went down to baseline levels. Insomnia was the most distressing symptom at day 0 (reported by 32% of participants). |
| Bieri et al. (2008) (49, 50) |
Allo HCT (N=124) AML (n=40), ALL (n=20), CML (n=31), CLL (n=1), MDS (n=8), Lymphoma (n=14), MM (n=1), MPS (n=3), AA (n=6) |
Age: Median = 34 Range = 14-65 Gender: M = 79 F = 45 |
Cross-sectional; Median of 7.3 years post-HCT |
EORTC QLQ-C30 |
Descriptive statistics, t-test |
Significantly higher sleep disruption among HCT patients compared to Norwegian population norms. Unclear where normative data came from. Difference of .33 SD. Univariate analysis indicated that employment status was associated with sleep disruption. |
| Bishop et al. (2007) (50) |
HCT (N=177), Partners (N=177), Controls (N=133) Allogeneic=78 (44%), Autologous=99 (56%) AML or ALL (39%), CML (22%), Breast cancer (18%), Lymphoma (21%) |
Mean Age: 50 (10) Gender: F = 50% Race: White = 94% |
Cross-sectional; Mean of 7 years (84 months) post-HCT (inclusion criteria: >12mo post-HCT) |
MOS-Sleep | Mixed Effect Linear Models |
Patients showed significantly higher rates of sleep problems than controls (ES=.39). Partners showed significantly higher rates of sleep problems than controls (ES=.22). |
| Boland et al. (2013) (60) |
Auto HCT (n=29), Allo HCT (n=3), Tandem HCT (n=10) MM (100%) MEL (n=29), maintenance lenalidomide (n=3), maintenance interferon alpha (n=1) |
Age: Median: 60 Range: 41-71 Gender: M = 17 F = 15 |
Cross-sectional: Mean 5.5 years post- diagnosis (range 2-12) |
EORTC QLQ C-30 |
Spearman’s correlations |
Sleep disruption significantly correlated with serum IL-6 levels (p=.02) |
| Boonstra et al. (2011) (37) |
Hospitalized HCT (N=69) Allo (n=46), Auto (n=23) Disease sites not reported |
Gender: Male = 41 Female = 26 |
Cross-sectional; Day14 post-HCT (reflective of 2 week period) |
ISI | Descriptives and Chi- Square tests |
No insomnia = 26%, subthreshold insomnia = 48%, Clinically significant insomnia (moderate) = 23%, Clinically significant insomnia (severe) = 3%. Female and allo patients were more likely to report insomnia (no observed differences in age). Toileting (85%), staff interruptions (80%), physical symptoms (41%), anxiety-self (39%), anxiety-others (35%), & noise (24%) most common reasons for sleep disruption. |
| Cohen et al. (2012) (28) |
Diverse HCT (N=164) Allo (62%), Auto (38%) Disease sites not reported HD (n=24), NHL (n=21), AML (n=11) 38 Chemo, 20 Radiochemo |
Mean Age: 45 Range = 19-74 Gender: M = 56% F = 44% Race: Black = 15% Latino = 23% Caucasian = 62% |
Longitudinal; 8 assessments: Pre-HCT – Day 100 post-HCT |
MDASI | Longitudinal Linear Mixed Models, Correlations |
Sleep disruption was one of the five worst reported symptoms; associated with myeloablative regimens and worse functional status. |
| Danaher et al. (2006) (24) |
HCT (N=20 at baseline; N=17 post-HCT) Auto =10 (59%), Allo = 7 (41%) Lymphoma (23%), CML (6%), AML (18%), ALL (6%), MM (29%), Myelofibrosis (12%), Plasma cell leukemia (6%) |
Mean age: 48.65 (23-64) Gender: M = 45% F = 55% Race: Caucasian = 35%, Black = 40%, Latino = 15%, Asian = 5%, Other = 5% |
Longitudinal; Pre-HCT & 5 days & 8 days post-HCT |
EORTC QLQ-C30 |
t-tests | Sleep disruption significantly worse post-HCT. |
| De Souza et al. (2002) (77) |
Allo HCT (N=26) All in complete remission BM (n=13), PBSC (n=13) CML (n=21), AML (n=3), MDS (n=1), ALL (n=1) |
Age: Range = 19-61 Gender: M = 14 F = 12 |
Cross-sectional; Mean of 1248 days post-HCT |
WHOQOL- 100: Single item assessment: “Do you have difficulties with sleeping?” |
Wilcoxon rank sum, Kruskal- Wallis’ tests |
No differences in sleep between patients receiving BM versus PBSC. |
| Diez-Campelo et al. (2004) (39) |
RIC Allo HCT (n=47), Auto HCT (n=70) AML (n=15), ALL (n=3), CML (n=5), MDS (n=7), NHL (n=3), HD (n=11), Breast cancer (n=6), MM (n=29), CLL (n=4), Amyloidosis (n=1) FLU/MEL or FLU/BU (n=47), BEAM (n=37), BU/MEL (n=8), CY/ carboplatin/thiotepa (n=6), MEL (n=11), BU/CY (n=7), CY/TBI (n=1) |
Age Range = 16- 70 |
Longitudinal; 6 assessments: days +7, +14, +21, +90, +270, +360 post-HCT |
FACT sleep disruption item: “I am sleeping well” |
Descriptives | 14.3% of allo-RIC and 26.3% of auto patients had problems sleeping at one year post-transplant (p=.29). |
| Enderlin et al. (2013) (7) |
Auto HCT (N=12) MM only All participants on the Total Therapy 3 protocol |
Age: Mean = 61 Range = 48-72 Gender: M = 10 F = 2 Race: Caucasian = 10 African American = 2 |
Cross-sectional; Pre-HCT (one assessment prior to, one assessment after chemo cycle) |
Polysomnogra phy |
Descriptives | Patients had a short sleep time, excessive time spent awake after sleep onset, poor sleep efficiency, more time in non-REM sleep, low arterial oxygen saturation, elevated periodic limb movements as measured by polysomnography. |
| Faulhaber et al. (2010) (44) |
Allo HCT (N=61) CML (37.7%), Severe AA (21.3%), AML (14.7), ALL (8.1%), NHL (6.5%), HD (4.9%), Other (6.5%) BU/CY (65.6%), RIC (18%), Cy (9.8%), TBI/CY (6.6%) |
Mean Age: 36.5 (12.3) Gender: M = 54.1% F = 45.9% |
Cross-sectional; 1 – 10 years post-HCT |
DSM-IV-TR criteria for sleep disorders |
multivariate analysis |
The prevalence of sleep disorders was 26.2%. Multivariate analysis indicated that busulfan-cyclophosphamide was an independent risk factor for sleep disorders (included sex & age). |
| Frick et al. (2006) (23) |
HCT (N=282) Allo (35%), Auto (62%) AML/MDS (11.7%), ALL (5%), CML (16%), HD (4.3%), NHL (29.9%), MM (29.5%), Other (3.6%); (97% hematological malignancies) |
Age: Median = 48.5 SD=11.9 Gender: F = 39% |
Cross-sectional; Pre- HCT |
EORTC QLQ-C30 |
Pearson’s Correlation Coefficient |
Compared patients to sample of German population – 36.6 patients versus 16.4 population (no SDs or SEs given). Sleep disruption was positively correlated with problematic social support (.183) |
| Frodin et al. (2011) (25) |
Auto HCT (N=111) MM (n=56), Lymphoma (n=32), Testicular cancer (n=3), AML (n=2), Multiple sclerosis (n=1) Conditioning: MEL (n=56), BEAM (n=33), CEC (n=3), BU/MEL (n=2), ZAM (Aavados, ARA-C, Melphalan) (n=2) |
Based on 96 of the patients: Age: Mean = 54 (12) Gender: M = 62 F = 34 |
Longitudinal; Baseline, Week 1, Week 2, Week 3, Week 4, Month 2, Month 3, Month 6, Year 1, Year 1.5, Year 2, Year 2.5, & Year 3 |
EORTC QLQ-C30 |
The results are presented using descriptive statistics, means adjusted for gender and age |
Worst sleep disruption at 2 weeks post-HCT. Sleep returned to baseline levels by 2 months post-HCT, and remained relatively stable thereafter through the 3 year follow up. Increase of 1.1 SD from pre-HCT baseline to 2 week follow up. Sleep disruption did not differ between myeloma and lymphoma patients. |
| Gallardo et al. (2009)(61) |
Allogeneic BMT (N=820; N=150 QOL assessed) Peripheral Blood Group (N=410): AML(25.9%), ALL (24.1%), CML (30.7%), MM (2.7%), NHL (7.3%), HD (0.5%), MDS (7.8%), Other (1%) Bone Marrow Group (N=410): AML (25.9%), ALL (24.1%), CML (30.7%), MM (2.7%), NHL (7.3%), HD (0.5%), MDS (7.8%), Other (1%) Peripheral Blood Group: Conditioning regimen with TBI=198 (48.3%) Bone Marrow Group: Conditioning regimen with TBI=200 (48.8%) |
Peripheral Blood Group (N=410): Age: Median = 35 Range = 15-59 Gender: M = 58.9% F = 41.1% Bone Marrow Group (N=410): Age: Median = 35 Range = 15-59 Gender: M = 62.3% F = 37.7% |
Retrospective; Follow up for alive patients: Median 43.8 months for patients receiving peripheral blood, Median 46.6 months for patients receiving bone marrow. |
EORTC QLQ-C30, Spanish Version |
Chi-square, t tests |
There were no significant differences in sleep difficulties reported between patients who received bone marrow (n=73, M=15.9, SD=26.7) versus peripheral blood (n=77, M=18.2, SD=26.2). |
| Gruber et al. (2003) (29) |
HCT (N=163) Allo (85%), Auto (12%), Syngenic (3%) Included both disease free & relapsed patients CLL/CML (n=69), ALL/AML (n=58), Other (n=36) |
Age at BMT: Median = 34 (9.2) Gender: M = 62.6% F = 37.4% |
Cross-sectional; Within 16 years post- HCT; (inclusion criteria: ≥2yrs post- HCT, transplanted b/w 1979 - 1996) |
SF-36, EORTC QLQ-C30, SIP, Herschbach Stress in Cancer Patients |
Mann– Whitney analysis, correlations |
Unemployed, divorced, and distressed patients reported significantly greater sleep problems. |
| Grulke et al. (2011) (26) |
Quantitative review of 33 papers reporting EORTC scores in HCT and covering 2800 patients Range of participants (15-415), Total N=2804 Allo=52.6% Auto=48.4% Acute leukemia (28%), CML (15.3%), other hemaological diseases (42.1%), solid tumors (14.8%) |
Age Range (14- 70) Gender: M = 50.1% |
Longitudinal; Pre-HCT, During Hospitalization, At Discharge, Up to 6 months, 7-12 months, 1-3 years, >3 years |
EORTC QLQ-C30 |
Categorized data by time of assessment, unweighted arithmetic means. |
Sleep problems increase during inpatient stay then return to baseline levels following discharge (change of 25 points). Sleep problems described by authors as “persistent” and at a “high level”. |
| Gulbrandsen et al. (2004) (32) |
Auto HCT (N=274) MEL/Prednisone only (n=203), MM only |
Not reported | Longitudinal; Pre- HCT, 1 month, 6 months, 12 months, 24 months, & 36 months post-HCT |
EORTC QOLQ-C30 |
Linear Regression model with forward stepwise selection |
Reference population of population-based study of 3000 Norwegians aged 18-93 years Statistically significant difference between newly diagnosed multiple myeloma patients and population norms, small in magnitude with worse scores in patients. |
| Hacker et al. (2003) (78) |
HCT (Pre-HCT N=16, 6 Weeks post- discharge N=8) Allo (n=11), Auto (n=5) Lymphoma (n=4), CML (n=3), AML (n=3), ALL (n=1), MM (n=3), Myelofibrosis (n=3) |
Mean Age: 46.56 (11.31) Gender: M = 50% F = 50% Race: White = 10 Black = 2 Latino = 2 Native American = 1 Asian = 1 |
Longitudinal; 4 assessments: pre-HCT, hospital discharge, 2 weeks post-discharge, 6 weeks post-discharge |
EORTC QLQ-C30 |
One-way repeated measures ANOVA with paired samples t-tests and Bonferroni corrections |
Sleep differences were found between T1 (M=41.67) and T2 (M=73.33) (baseline to immediately before discharge), & between T2 and T3 (M=33.33) (immediately before discharge to 2 weeks post-hospitalization). T4 M=33.33 |
| Harder et al. (2002) (79) |
HCT (N=40) Allo HCT (87.5%); Allo MRD=26, Allo MUD=9, Auto=5 ALL (n=8), AML (n=10), CML (n=6), NHL (n=6), MDS (n=4), MM (n=4), AA (n=2) All had TBI up to 12 Gy, Intrathecal tx (n=11), Conditioning Regimen: CY (n=12), ARA-C/CY (n=19), VP-16/CY (n=9) |
Age at HCT: Mean = 37.2 Range = 15-55 Gender: M = 24 F = 16 |
Cross-sectional; 22-82 months post-HCT |
EORTC QLQ-C30 |
Descriptives | Sleep disruption M = 18.3 (SD=22.6) Sleep disturbances were one of the most commonly reported complaints. |
| Hayden et al. (2004) (53) |
Sibling Allo HCT (N=51) (original sample of 75 HCT patients) CY/TBI (32%); BU/CY (68%) |
Based on 51 patients alive in 2003: Age at BMT: Median = 35 Range = 14-55 Gender: M = 31 F = 20 |
Cross-sectional; Median of 98 months post-HCT |
EORTC QLQ-C30 |
Descriptives | No difference in sleep disruption between HCT patients and reference population. Reference population not described. |
| Hendriks & Schouten(200 2) (45) |
HCT (N=52 at T1; N=33 at T2) Auto (81%), Allo (19%) at T1 Relapse free Lymphoma (40%), Breast cancer (29%), Acute leukemia (29%) |
Age: Mean = 41 Gender: M = 42% F = 58% |
Longitudinal; Mean of 2.5 years & 4.5 years post-HCT |
EORTC QLQ-C30 |
Mann- Whitney U test, correlations |
No differences in sleep disruption over time. Patients reported more sleep disruption than general Norwegian population. Physicians tended to underestimate sleep problems. |
| Hjermstad et al. (2004) (33) |
HCT (N=130), Chemotherapy patients (N=118) Allo (n=61), Auto (n=69) HCT Group: HD (n=15), high grade NHL (n=43), low grade NHL (n=11), CML (n=31), AML (n=19), ALL (n=11) |
Age at baseline: Median = 35 Range = 17-55 Gender: M=56% F=44% |
Longitudinal; Pre-HCT & 3-5 years post-HCT |
EORTC QLQ-C30 |
Wilcoxon’s test or one-way ANOVA as appropriate. Confidence intervals for graphic illustrations |
No statistically significant changes in sleep disruption from baseline to 3-5 years in allo or auto groups, but CT group reported improved sleep quality over time. Allo patients reported better sleep, auto worse sleep than general Norwegian population at baseline and 3-5 years post- HCT. |
| Kiss et al. (2002) (57) |
Allo HCT (N=28) Included both disease free & relapsed patients CML only CY/TBI/ARA-C (n=27), BU/CY (n=1) |
Age: Mean = 32.6 Range = 18.2- 49.2 Gender: M = 16 F = 12 |
Cross-sectional; Mean of 13.2 years post- HCT |
Single item from a symptom checklist developed at the hospital |
Descriptives | 21 of 26 patients were mildly bothered by sleep disruption while 5 of 26 were moderately or severely bothered. |
| Kopp et al. (2005) (51) |
HCT (N=34) & age- and sex-matched non-cancer controls (N=68) Allo HCT (61.8%), Auto HCT (38.2%) Chronic leukemia (14.7%), Acute leukemia (47.1%), MM (8.8%), MDS (5.9%), Solid tumor (2.9%), Lymphoma (17.6%), Sarcoma (2.9%) TBI fractionated (67.6%), TBI single dose (8.8%), No (23.5%) |
Mean Age: 44.7 (9.4) Gender: M = 50% F = 50% |
Cross-sectional; Patients were at least 5 years post-HCT |
EORTC-QLQ C30 |
Mann- Whitney U- tests |
No significant differences in sleep between HCT patients and healthy controls; patients had worse sleep by .06 SD. |
| Messerer et al. (2008) (55) |
Allo HCT (N=121) & Chemotherapy (N=221) Disease free AML Only |
Allogeneic BMT: Age at diagnosis: Median = 38 Gender: F = 52% |
Cross-sectional; HCT patients were a median of 8 years post-HCT; Chemo patients were a median of 9 years post- chemo |
EORTC QLQ-C30 |
Chi-square, stratified Mantel- Haenszel, non parametrics |
No difference in sleep disruption between allo HCT patients and chemotherapy patients (.06 SD). |
| Mosher et al. (2011) (56) |
HCT (N=406) Auto (60.3%), Allo (29.1%) Relapse free NHL (22.4%), HD (6.2%), AML/CML (11.6%), ALL/ CLL (3.4%), MDS/MPS (8.4%), MM / Amyloidosis (33.7%), Other (1.5%) |
Mean Age: 49.25 (12.82) Gender: M = 51.5% F = 47.8% Race: Caucasian = 83.7%, African American = 5.7%, Hispanic = 3.9%, West Indian = 1.5%, Other = 4.4% |
Cross-sectional; Mean of 21 months post- HCT |
FACT-BMT | Percentage | 80% of patients reported sleeping well. |
| Pallua et al. (2010) (47) |
Allo HCT (N=100) AML (41%), CML (22%), ALL (12%), Lymphoma (6%), MDS (6%), MM (4%), AA (4%), MPD (2%), PNH (2%), CLL (1%) |
Age: Mean = 46.3 (14.7) Range = 16 – 76 Gender: M = 55% F = 45% |
Cross-sectional; Mean of 95.4 months post- HCT |
EORTC QLQ-C30 |
Effect Sizes = Cohen’s d, t- tests, one way ANOVA |
No significant association between sleep disruption and time since transplant. Sleep disruption was greater in patients with ongoing GVHD compared to patients with no GVHD (ES=.31; not significant). Difference in sleep disruption between HCT patients and the reference Austrian population (ES=.31). |
| Rischer et al. (2009) (4) |
HCT (N=50 at pre-HCT, N=32 at Day 100 post-HCT) Allo (78%), Auto (22%) AML (36%), MM (22%), NHL (14%), MDS (10%), Osteomyelofribrosis (10%), Others (8%) |
Mean Age: 53.3 (12.6) Gender: M = 74% F = 26% |
Longitudinal; 3 assessments: Pre-HCT, During Hospital Stay, & Day 100 post-HCT |
PSQI, Sleep Diary |
Chi-square, McNemar tests, repeated measures ANOVA Spearman’s correlation coefficients |
Prevalence of sleep disruption 32% prior to HCT, 77% during hospitalization, 28% at day 100. During hospitalization: difficulties maintaining sleep was the most reported sleep dimension (81.8% moderate to severe, mainly caused by noises & toileting), then non-restorative sleep (61.4%), difficulties falling asleep (52.3%), difficulties falling back asleep (47.7%), & early a.m. awakenings (20.5%). Allo patients had significantly worse sleep than auto patients. Increases in sleep disruption correlated with increases in fatigue, physical functioning, treatment-specific distress but not anxiety and depression |
| Sherman et al. (2003) (35) |
Pre-BMT (N=61) MM (85.3%), MGUS (8.2%), Amyloid (6.6%) |
Age: Mean = 57 (12.3) Gender: M = 63.9% F = 36.1% Race: White = 91.8% Other = 8.2% |
Cross-sectional; Mean of 7.4 months post- diagnosis; All were assessed prior to BMT |
Epworth Sleepiness Scale |
Descriptives, Percentages, and Spearman Correlations |
Pilot Study 43.33% exceeded the clinical cutoff of daytime sleepiness. Older age associated with more daytime sleepiness. Lower hemoglobin levels associated with more daytime sleepiness. |
| Syrjala et al. (2005) (52) |
HCT survivors (N=137) & age- and sex- matched controls from the NHANES study (N=4020) Allo (88%), Auto (12%) CML (chronic phase) (45%), CML (accelerated or blast crisis) (7%), Acute leukemia in remission (14%), Acute leukemia in relapse (8%), Lymphoma in remission (10%), Lymphoma in relapse (7%), MDS (7%), Other (4%) |
BMT survivors: Mean Age: 34.6 (9.0) Gender: M = 48% Race: White = 95% Non-white, Non- Hispanic = 3% Hispanic = 2% |
Cross-sectional; 10 years post-HCT |
Checklist of symptoms developed for the study |
Paired t-tests, McNemar, Wilcoxon signed ranks tests Alphas set at .01. |
14% of survivors reported moderate or severe sleep problems compared with 9% of controls; results were not statistically significant. |
| Watson et al. (2004) (59) |
HCT (N=171) & chemotherapy (n=310) Allo (n=97), Auto (n=74) CY (n= 147), BU (n=26), mesna (n=27), MEL (n=18). TBI (n= 135) |
For all groups: Age: Median = 39 Range = 15-58 Gender: M = 45% F = 55% |
Cross-sectional; at least 1 year post-HCT |
EORTC QLQ-C30 |
Wilcoxon two sample test, t- test, Generalized linear models |
45% of patients reported sleep disruption. Sleep disruption more severe in older patients than younger patients. No difference in sleep disruption between allo, auto, or chemotherapy groups. No differences in sleep disruption between males and females. |
| Wettergren et al. (2008) (34) |
Auto HCT (N=22), Compared to Swedish population norms HD (n=1), NHL (n=3), AML (n=6), MM (n=12) |
Age: Median = 50 Range = 31 - 66 Gender: M = 13 F = 9 |
Longitudinal; Pre-HCT & 1 year post-HCT |
EORTC QLQ-C30 |
McNemar test, paired t-test |
No significant changes in sleep disruption (ES=.03), no differences compared to Swedish population norms |
| Worel et al. (2002) (46) |
Allo or syngeneic HCT (N=155) Disease-free ALL/AML (n=9/43), CML (n=56), MM (n=5), MDS (n=7), NHL (n=15), AA (n=19), Testicular cancer (n=1) TBI/CY, CY, CY/ATG, BU/CY |
Age: Median = 34 Range = 17-57 Gender: M = 86 F = 69 |
Cross-sectional; at least 2 years post-HCT |
EORTC QLQ-C30 |
Descriptives | Divided patients 2-5 years post-HCT & more than 5 years post- HCT. Of all patients, 45% had none or slight sleep disruption, 43% had moderate sleep disruption, and 12% had severe sleep disruption. Percentages were comparable for patients 2-5 years post-HCT and more than 5 years post-HCT. |
AA: aplastic anemia; ALL: acute lymphoid leukemia; AML: acute myeloid leukemia; ARA-C: cytarabine; ATG: anti-thymocyte globulin; BEAM: carmustine, etoposide, cytarabine, melphalan; BU: busulfan; CLL: chronic lymphocytic leukemia; CY: cyclophosphamide; DSM-IV-TR: Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision; EORTC QLQ-C30: European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core - 30; FACT-BMT: Functional Assessment of Cancer Therapy – Bone Marrow Transplant; FLU: fludarabine; HCT: hematopoietic cell transplant; HD: Hodgkin’s disease; ISI: Insomnia Severity Index; MDASI: M.D. Anderson Symptom Inventory; MDS: myelodysplastic syndrome; MEL: melphalan; MGUS: monoclonal gammopathy of undetermined significance; MM: multiple myeloma; MOS: Medical Outcomes Study; MPS: myeloproliferative syndrome: MRD: matched related donor; MUD: matched unrelated donor; NHL: non-Hodgkin’s lymphoma; PNH: paroxysmal nocturnal hemoglobinuria; PSQI: Pittsburgh Sleep Quality Index; RIC: reduced-intensity conditioning; SF-36: Medical Outcomes Study Short Form – 36; SIP: Sickness Impact Profile; TBI: total body irradiation; VP-16: etoposide; WHOQOL100: World Health Organization Quality of Life Questionnaire - 100