Quality of Life of Children with Acquired Aplastic Anemia

Bone Marrow Transplantation Versus Immunosuppressive Therapy

Abstract

A retrospective comparative study was designed to assess the Quality of Life (QOL) in a group of children with acquired aplastic anemia (AA) treated with bone marrow transplantation (BMT) from HLA-matched sibling donors or immunosuppressive therapy (IST). We evaluated 19 children under the age of 14 years with AA who were treated in the Hospital of Hyogo College of Medicine from 1984 to 1999. Seven patients received IST and 13 patients BMT. The BMT group included one patient who was initially given 1ST. The good response rates for treatment were 85% for BMT and 86% for 1ST. No significant difference was noted between the two groups. Questionnaires for QOL assessment were completed by the patients' parents in November 1999. The results of a comparative study of QOL indicated that both groups equally showed an excellent level of satisfaction with their treatment. As for satisfaction in daily life, the IST group reported better status than the BMT group did. The physical late effects of BMT, such as chronic GVHD, affected QOL in the BMT group. Although many BMT patients reported marriage and employment as future anxiety, the IST patients were most anxious about relapse. The late effects of the treatment on QOL should be considered cautiously for the choice of an initial treatment of AA.