Quality of life and recovery after graft-versus-host disease

Acute and chronic graft versus host disease (GVHD) has a significant impact on short- and long-term morbidity as well as mortality in patients undergoing hematopoietic-cell transplantation (HCT). As a result of the physical as well as emotional aspects of the transplant process and development of GVHD, quality of life (QOL) in transplant survivors can be adversely affected. The strongest association between reduced QOL and impaired functional status following HCT is the presence of chronic GVHD. Chronic GHVD can have a negative impact on an individual's general health and mental health, and can lead to the development of functional impairments and activity limitations. In HCT survivors without chronic GVHD, self-reported QOL tends to be very similar to that in comparison groups by 1–2 years after HCT. In addition, in individuals who have been successfully treated for chronic GVHD, QOL and overall health status are not different from those with no history of chronic GVHD. These findings suggest that effective new therapies for chronic GVHD are essential, as are standardized tools for the assessment of QOL and functional outcomes in HCT survivors with chronic GVHD in order to gain a better understanding of the overall impact of the condition, as well as the effectiveness of new treatments.