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

Jennifer M. Knight, Karen L. Syrjala, Navneet S. Majhail, Michael Martens, Jennifer Le-Rademacher, Brent R. Logan, Stephanie J. Lee, Paul B. Jacobsen, William A. Wood, Heather S.L. Jim, John R. Wingard, Mary M. Horowitz, Muneer H. Abidi, Mingwei Fei, Laura Rawls, J. Douglas Rizzo

Research output: Contribution to journalArticle

10 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)2256-2263
Number of pages8
JournalBiology of Blood and Marrow Transplantation
Volume22
Issue number12
DOIs
StatePublished - Dec 1 2016

Keywords

  • Hematopoietic cell transplantation
  • Hematopoietic recovery
  • Patient-reported outcomes
  • Quality of life
  • Socioeconomic status
  • Survival

ASJC Scopus subject areas

  • Hematology
  • Transplantation

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    Knight, J. M., Syrjala, K. L., Majhail, N. S., Martens, M., Le-Rademacher, J., Logan, B. R., Lee, S. J., Jacobsen, P. B., Wood, W. A., Jim, H. S. L., Wingard, J. R., Horowitz, M. M., Abidi, M. H., Fei, M., Rawls, L., & Rizzo, J. D. (2016). 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. Biology of Blood and Marrow Transplantation, 22(12), 2256-2263. https://doi.org/10.1016/j.bbmt.2016.08.016