Longitudinal trajectory of frailty in blood or marrow transplant survivors: Report from the Blood or Marrow Transplant Survivor Study
| Autor: | Emily Ness, F. Lennie Wong, Stephen J. Forman, Merve Pamukcuoglu, Mukta Arora, Yanjun Chen, Saro H. Armenian, Jessica Wu, Liton Francisco, Alysia Bosworth, Daniel J. Weisdorf, Lindsey Hageman, Smita Bhatia, Michelle Kung, Wendy Landier |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Male Cancer Research medicine.medical_specialty Adolescent medicine.medical_treatment Hematopoietic stem cell transplantation Disease Article 03 medical and health sciences Young Adult 0302 clinical medicine Internal medicine medicine Humans 030212 general & internal medicine Survivors Adverse effect Aged Bone Marrow Transplantation Retrospective Studies Aged 80 and over Frailty business.industry Muscle weakness Odds ratio Middle Aged Oncology 030220 oncology & carcinogenesis Cohort Female Underweight medicine.symptom business Cohort study |
| Zdroj: | Cancer |
| ISSN: | 1097-0142 |
| Popis: | Background Blood or bone marrow transplantation (BMT) survivors with frailty are at a higher risk of subsequent mortality. Longitudinal trends in the frailty state are not known and could help identify vulnerable subpopulations at risk of subsequent adverse events. Methods This study included a cohort of 470 autologous and allogeneic BMT recipients who had survived ≥2 years after BMT and completed a baseline questionnaire (t1) at a median of 7.3 years after BMT and a follow-up questionnaire (t2) 13.2 years after t1. The main outcome was change in frailty state between t1 and t2. Frailty phenotype was defined as exhibiting ≥3 of the following characteristics: clinically underweight, exhaustion, low energy expenditure, slow walking speed, and muscle weakness. The following categories of change in frailty state were evaluated: worsened, improved, and stable. Results Of the 470 participants, 36.4% were aged ≥60 years at t1, and 50.6% were men. The prevalence of frailty increased from 4.8% at t1 to 9.6% at t2. Worsening was observed in 18.8% of patients, and improvement was reported in 9.7%. Pre-BMT exposure to vincristine (odds ratio [OR], 2.1; 95% CI, 1.3-3.39) was associated with worsening. Female sex (OR, 1.5; 95% CI, 0.93-2.4) was associated with a trend toward worsening. Pre-BMT exposure to vincristine (OR, 2.79; 95% CI, 1.44-5.43), a history of chronic graft-versus-host disease (OR, 2.58; 95% CI, 1.2-5.5), and grade 3 and 4 chronic health conditions at t1 (OR, 2.1; 95% CI, 1.08-4.33) were associated with frailty at t2. Conclusions In a cohort of BMT survivors who were followed longitudinally for a median of 20.6 years from BMT, the frailty status worsened for approximately20% over a 13-year timespan. BMT survivors who are at risk for worsening frailty could benefit from targeted interventions. |
| Databáze: | OpenAIRE |
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