ArticleSupportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer2026
Fatigue and quality of life in the early phase after allogeneic hematopoietic stem cell transplantation: dynamics and the impact of graft-versus-host disease.
Article in Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeFatigue and impaired quality of life are common after allogeneic hematopoietic stem cell transplantation (allo-HSCT), particularly in patients who develop graft-versus-host disease (GVHD). This study assessed the dynamics of fatigue and quality of life during the first 6 months after allo-HSCT and evaluated their association with GVHD status and response to GVHD treatment.
methodsThis prospective study represents an early-phase analysis from a larger longitudinal project evaluating patient-reported outcomes after allo-HSCT across six predefined assessment points up to 24 months. The primary complete-case analysis included 28 adult patients with complete assessments at the first three timepoints: within 24 h after transplantation (T1), at 1 month (T2), and at 6 months (T3). Fatigue was assessed using FACIT-F and BFI, and quality of life using FACT-BMT. Patients were grouped according to GVHD status and response to GVHD treatment. Longitudinal analyses were performed using linear mixed-effects models. Additional sensitivity analyses were conducted using all available early-phase PRO data.
resultsFourteen patients developed GVHD during early follow-up. Quality of life improved and fatigue decreased over time (all p < 0.001). Patients who developed GVHD reported consistently worse outcomes, with lower FACT-BMT and higher fatigue across the first 6 months after transplantation (all p < 0.001), without significant time-by-GVHD interactions. In exploratory analyses within the GVHD subgroup, responders had better quality of life and lower fatigue than non-responders (FACT-BMT: p = 0.016; BFI: p < 0.001; FACIT-F: p = 0.017). Fatigue was strongly associated with quality of life (BFI: r = -0.813; FACIT-F: r = 0.857; both p < 0.001) and remained an independent correlate of FACT-BMT in multivariable models.
conclusionsIn this early-phase complete-case cohort, development of GVHD during early follow-up was associated with persistently worse quality of life and higher fatigue during the first 6 months after allo-HSCT. Fatigue was strongly associated with patient-reported outcomes and may represent a clinically relevant, potentially modifiable target for supportive care. These findings should be interpreted in light of the small sample size, complete-case design, follow-up-defined GVHD classification, and potential selection bias.
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