gms | German Medical Science

Objective: Haematological Stem Cell Transplantation (HSCT) is one of the most invasive treatments in oncology. Only a few scientific results are published about the problems in the later phases of rehabilitation process after allogenic HSCT. Since 1993 we have treated more than 1300 patients, 20 % of this group have been treated after day 365 post transplant. For this special group of patients we have established a specific 3 week interdisciplinary rehabilitation program in 2003. Criteria for participation in the program were: being allogenicly transplanted for more than one year, Karnovsky Index > 80% and minor complications after HSCT. The program includes daily group-meetings and a continuously physical-therapy-program. It is also possible to participate in the regular rehabilitation program, additionally. Also, the families of the participants are invited for two days. In co-operation with several transplantation units in Germany we have included 32 patients in the program during the last three years.

Materials and methods: We have implemented a system of medical information and psychosocial documentation. To describe the global situation of the patients we also use the following questionnaires: EORTC QLQ C30 – V30, HADS, MFI and FFB-MOT.

Results: A number of the early problems have turned into chronic symptoms: depressive mood and anxiety, problems in family and partnership, sexual dysfunction and vocational reintegration. There are medical problems like chronic GvHD and infections. A chronic fatigue syndrome seems to be the most important symptom. Personal reports of the participants show: the feeling of not being alone and to share similar problems with other patients is a very important positive effect of the program and that the atmosphere in the group is especially valuable and helpful in reducing emotional distress.

Conclusion: A special rehabilitation program has an important influence on the physical and psychosocial reintegration of HSCT patients in later phases of the rehabilitation process. Also, it helps to identify medical and psychosocial needs and to provide psychosocial and medical support. Next year, we will offer this program twice a year and will continue to evaluate its effects.