Patient-Reported Outcomes and Socioeconomic Status as Predictors of Clinical Outcomes after Hematopoietic Stem Cell Transplantation: A Study from the Blood and Marrow Transplant Clinical Trials Network 0902 Trial. Biol Blood Marrow Transplant 2016 Dec;22(12):2256-2263
Date
08/28/2016Pubmed ID
27565521Pubmed Central ID
PMC5116244DOI
10.1016/j.bbmt.2016.08.016Scopus ID
2-s2.0-84992110582 (requires institutional sign-in at Scopus site) 26 CitationsAbstract
This secondary analysis of a large, multicenter Blood and Marrow Transplant Clinical Trials Network randomized trial assessed whether patient-reported outcomes (PROs) and socioeconomic status (SES) before hematopoietic stem cell transplantation (HCT) are associated with each other and predictive of clinical outcomes, including time to hematopoietic recovery, acute graft-versus-host disease, hospitalization days, and overall survival (OS) among 646 allogeneic and autologous HCT recipients. Pretransplantation Cancer and Treatment Distress (CTXD), Pittsburgh Sleep Quality Index (PSQI), and mental and physical component scores of the Short-Form 36 were correlated with each other and with SES variables. PROs and SES variables were further evaluated as predictors of clinical outcomes, with the PSQI and CTXD evaluated as OS predictors (P < .01 considered significant given multiple testing). Lower attained education was associated with increased distress (P = .002), lower income was related to worse physical functioning (P = .005) and increased distress (P = .008), lack of employment before transplantation was associated with worse physical functioning (P < .01), and unmarried status was associated with worse sleep (P = .003). In this large heterogeneous cohort of HCT recipients, although PROs and SES variables were correlated at baseline, they were not associated with any clinical outcomes. Future research should focus on HCT recipients at greater psychosocial disadvantage.
Author List
Knight JM, Syrjala KL, Majhail NS, Martens M, Le-Rademacher J, Logan BR, Lee SJ, Jacobsen PB, Wood WA, Jim HSL, Wingard JR, Horowitz MM, Abidi MH, Fei M, Rawls L, Rizzo JDAuthors
Mary M. Horowitz MD, MS Professor in the Medicine department at Medical College of WisconsinJennifer M. Knight MD, MS Professor in the Psychiatry and Behavioral Medicine department at Medical College of Wisconsin
Brent R. Logan PhD Director, Professor in the Data Science Institute department at Medical College of Wisconsin
Michael Martens PhD Assistant Professor in the Data Science Institute department at Medical College of Wisconsin
J. Douglas Rizzo MD, MS Director, Center Associate Director, Professor in the Medicine department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
AdultAged
Female
Graft vs Host Disease
Hematopoietic Stem Cell Transplantation
Hospitalization
Humans
Male
Middle Aged
Patient Reported Outcome Measures
Prognosis
Quality of Life
Recovery of Function
Social Class
Survival
Treatment Outcome
Young Adult