Bone marrow transplantation (BMT) is a medical procedure that offers the potential for a complete cure of a patient's cancer, but it also introduces risks for severe psychological, interpersonal, financial and physical impairment. While the survival rate for BMT continues to rise, little is known about how this arduous and demanding treatment procedure affects the quality of lives of recipients and adjustment of survivors. A prospective longitudinal cohort design (total number of patients equal about 425) is proposed to follow groups of bone marrow transplant recipient survivors over time (up to 24 months). Complete illness history and psychosocial status will be assessed one month before BMT. New patients will enter the study at approximately the rate of 8 to 9 per month; to meet the target sample size of 425, new cases will be accepted for 51 months. Interviews will be conducted with patients at The Johns Hopkins Hospital Oncology Center before their transplants and at intervals post-BMT of 3, 6, 12, 18, and 24 months. The proposed study has both descriptive and predictive goals. First, the purpose is to describe the experience of bone marrow transplantation and how it affects the lives of recipients; and second, the research will examine the relationships between the psychological, social, economic, and health resources of the patients and their subsequent adjustment and life satisfaction. In addition to information obtained by self-report from the patient, data will also be obtained from a family member, caregivers, and medical and social service records. Statistical analyses employed will be those appropriate to a cohort-sequential, multivariable, multiwave model with structured means.
