title: Predictors of physical outcomes in pediatric bone marrow transplantation.
abstract: The purpose of the present study was to investigate the hypothesis that family factors, in conjunction with clinical factors, are associated with physical outcomes in pediatric BMT. A prospective study of 68 pediatric patients (mean age = 7.5 years; ranging from 4 months to 18 years) undergoing BMT was carried out over a 6.5 year period. Physicians rated initial prognosis on a (0-5) scale which incorporated the child's diagnosis, known risk factors, and type of donor. Both parents individually completed two psychometrically sound questionnaires assessing family well-being and marital satisfaction. Cox proportional hazards survival analyses were performed to determine predictors of death (44% of the patients died). Potential predictor variables included were: initial prognosis, type of transplant, patient's age, socioeconomic status, marital satisfaction and family status, and family stress. Initial prognosis, as estimated by the physician, (RR = 0.62, 95% CI = 0.40, 0.97) was the best predictor of survival. Initial clinical factors are clearly critical in outcomes for pediatric BMT patients.
authors.affiliation: The Montreal General Hospital Research Institute and McGill University, Department of Medicine, QC, Canada.
authors.forename: P L
authors.initials: PL
authors.lastname: Dobkin
authors.forename: R M
authors.initials: RM
authors.lastname: Poirier
authors.forename: P
authors.initials: P
authors.lastname: Robaey
authors.forename: Y
authors.initials: Y
authors.lastname: Bonny
authors.forename: M
authors.initials: M
authors.lastname: Champagne
authors.forename: L
authors.initials: L
authors.lastname: Joseph
mesh_terms: D000206:Actuarial Analysis; D000293:Adolescent; D000328:Adult; D016026:Bone Marrow Transplantation / Q000401:mortality* / Q000523:psychology; D002648:Child; D002675:Child, Preschool; D005192:Family Health; D005260:Female; D006086:Graft vs Host Disease / Q000401:mortality; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D010290:Parents / Q000523:psychology; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology; D012307:Risk Factors; D011795:Surveys and Questionnaires; D015996:Survival Rate; D014184:Transplantation, Homologous / Q000401:mortality / Q000523:psychology; D016896:Treatment Outcome