Congress Abstracts 2006

57

SYMPTOM BURDEN IN PATIENTS UNDERGOING ALLOGENEIC BLOOD OR MARROW TRANSPLANTATION FOR AML/MDS. Lori Williams, RN, DSN, OCN^®, AOCN^®, Xin Shelley Wang, MD, MPH, Charles Cleeland, PhD, Gary Mobley, MS, and Sergio Giralt, MD, University of Texas M.D. Anderson Cancer Center, Houston, TX.

Symptom burden is the impact of all disease- and therapy-related symptoms on one's ability to function as one did before the onset of disease or therapy. Symptoms are experiences reported by patients, while toxicities are clinicians' evaluation of the effects of disease and treatment on patients. Toxicities of blood and marrow transplantation (BMT) are well described in the literature, but symptoms are not well reported. Lack of understanding of symptoms and symptom burden may result in failure to address symptoms and return patients to optimum functioning.

The purpose of this study was to describe symptom burden, including severity and interference, experienced by patients with AML/MDS undergoing allogeneic BMT. Research in cancer symptoms and side effects is an ONS research priority.

Cleeland and Reyes-Gibby's conceptual model of symptom burden was the theoretical framework for this study.

This longitudinal, descriptive study assessed symptom severity and interference using the M. D. Anderson Symptom Inventory in 30 patients undergoing allogeneic BMT for AML/MDS. Results of symptom assessment at 5 time points (baseline, nadir, engraftment, 30 days post-BMT and 100 days post-BMT) were analyzed using descriptive statistics and t-tests to identify significant differences in symptom severity and interference over time.

Mean global symptom severity was increased significantly from baseline at nadir (p=.00006), engraftment (p=.002), and 30 days post-BMT (p=.02), but returned to baseline by 100 days post-BMT (p=.3). Only the mean symptom severity of dry mouth remained significantly elevated (p=.006) at 100 days post-BMT. Mean global symptom interference was increased significantly from baseline at nadir (p=.002), engraftment (p=.04), 30 days post-BMT (p=.008), and 100 days post-BMT (p=.03). At day 100 post-BMT, the mean symptom interference with general activity (p=.04) and relations with other people (p.=.01) remained significantly elevated from baseline. These results corroborate reports that patients experience significant treatment side effects during BMT. Symptom interference with functioning continues to affect patients 3 months post-BMT. Findings indicate the need to investigate the impact of specific symptoms on symptom burden, explore interventions to decrease the severity of specific symptoms, and decrease symptom burden by assisting patients to regain physical and social functioning following BMT.