Association Between Baseline Patient-Reported Outcomes and Complications of Hematopoietic Stem Cell Transplantation.

Autor: Johnson PC; Department of Medicine, Division of Hematology & Oncology, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston Massachusetts. Electronic address: pcjohnson@mgh.harvard.edu., Bhatt S; Department of Medicine, Division of Hematology & Oncology, Massachusetts General Hospital, Boston, Massachusetts., Reynolds MJ; Department of Psychiatry, Massachusetts General Hospital & Harvard Medical School, Boston, Massachusetts., Dhawale TM; Department of Medicine, Division of Hematology & Oncology, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston Massachusetts., Ufere N; Harvard Medical School, Boston Massachusetts; Department of Medicine, Division of Gastroenterology, Massachusetts General Hospital, Boston, Massachusetts., Jagielo AD; Department of Psychiatry, Massachusetts General Hospital & Harvard Medical School, Boston, Massachusetts., Lavoie MW; Department of Psychiatry, Massachusetts General Hospital & Harvard Medical School, Boston, Massachusetts., Topping CEW; Department of Psychiatry, Massachusetts General Hospital & Harvard Medical School, Boston, Massachusetts., Clay MA; Department of Psychiatry, Massachusetts General Hospital & Harvard Medical School, Boston, Massachusetts., Rice J; Department of Psychiatry, Massachusetts General Hospital & Harvard Medical School, Boston, Massachusetts., Yi A; Department of Medicine, Division of Hematology & Oncology, Massachusetts General Hospital, Boston, Massachusetts., DeFilipp Z; Department of Medicine, Division of Hematology & Oncology, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston Massachusetts., Chen YB; Department of Medicine, Division of Hematology & Oncology, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston Massachusetts., El-Jawahri A; Department of Medicine, Division of Hematology & Oncology, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston Massachusetts.
Jazyk: angličtina
Zdroj: Transplantation and cellular therapy [Transplant Cell Ther] 2021 Jun; Vol. 27 (6), pp. 496.e1-496.e5. Date of Electronic Publication: 2021 Feb 25.
DOI: 10.1016/j.jtct.2021.02.029
Abstrakt: Hematopoietic cell transplantation (HCT) is a potentially curative therapy for hematologic malignancies, but it often results in significant toxicities and impaired quality of life (QOL). Although the value of patient-reported outcomes (PROs) is increasingly recognized in HCT, data are limited regarding the relationship between PROs and HCT complications. We conducted a secondary data analysis of 250 patients who were hospitalized for autologous or allogeneic HCT at Massachusetts General Hospital from 2011 through 2016. We assessed QOL (Functional Assessment of Cancer Therapy-General), mood (Hospital Anxiety and Depression Scale), and fatigue (FACT-Fatigue) at baseline. We abstracted from the Electronic Health Record (1) hospitalization during the first 100 days after HCT, (2) days alive and out of the hospital in the first 100 days after HCT, and (3) cumulative incidence of acute graft-versus-host disease (GVHD) among allogeneic HCT recipients. We assessed the association of baseline PROs with HCT complications using multivariable models adjusting for patient and transplant characteristics. Overall, 44.4% (111/250) of patients underwent an autologous HCT, 25.2% (63/250) received a myeloablative allogeneic HCT, and 30.4% (76/250) underwent a reduced-intensity allogeneic HCT. In multivariable logistic regression, higher anxiety (odds ratio [OR] = 1.14, P = .004) was associated with higher likelihood of rehospitalization within 100 days after HCT. In multivariable Poisson regression, lower fatigue (β = 0.003, P = .015) was associated with increased days alive and out of the hospital in the first 100 days post-HCT. In multivariable logistic regression, lower baseline QOL (OR = 0.97, P = .034), higher fatigue (OR = 0.95, P = .004), and higher depression (OR = 1.15, P = .020) were associated with increased likelihood of acute GVHD. Baseline PROs are associated with health care utilization after HCT and risk of acute GVHD in allogeneic HCT recipients. These findings underscore the potential utility of pretransplantation PROs as important prognostic factors for HCT.
(Copyright © 2021 The American Society for Transplantation and Cellular Therapy. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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