Type of hematological malignancy is crucial for the return to work prognosis: a register-based cohort study.
OBJECTIVE
The aims of this study were to determine the proportion of return to work (RTW) among sick-listed patients diagnosed with one of eight subtypes of hematological malignancies; to evaluate the influence of type of hematological malignancy, comorbidity, use of anxiolytics and antidepressants, socioeconomic and demographic factors on RTW; and to investigate if these associations differ between genders.


METHODS
We combined data from national registers on all Danish patients diagnosed with hematological malignancies between 2000 and 2007. A total of 1,741 patients on long-term sick leave were followed until RTW, emigration, permanent withdrawal from the labor market, death, or February 2012, whichever came first.


RESULTS
A total of 1,140 (65 %) patients returned to work. A strong association was found between type of diagnosis and RTW (p < 0.001), and the proportion of RTW was lowest for patients with multiple myeloma or acute leukemia compared to patients with Hodgkin lymphoma, diffuse large B-cell lymphoma, follicular lymphoma, chronic myeloid leukemia, and chronic lymphoid leukemia. Use of antidepressants or anxiolytics after diagnosis, gender, age, and educational level were also associated with RTW. Surprisingly, comorbidity was not associated with RTW (p = 0.94); gender only modified the association between age and RTW.


CONCLUSIONS
Two thirds of patients with hematological malignancies on sick leave RTW. A number of factors seem to lead to a poor prognosis, the hematological diagnosis being the most important, and these should be taken into account when performing studies on work outcome for patients with hematological malignancies.


CONCLUSIONS
Knowledge in this area should assist in identification of hematological cancer patients at risk of not returning to work so that early targeted rehabilitation interventions can be initiated.
Department of Hematology, Aarhus University Hospital, Tage Hansensgade 2, 8000, Aarhus C., Denmark, trinhors@rm.dk.
Trine Allerslev
TA
Horsboel
Claus Vinther
CV
Nielsen
Bendt
B
Nielsen
Chris
C
Jensen
Niels Trolle
NT
Andersen
Annette
A
de Thurah
D000328:Adult; D014151:Anti-Anxiety Agents / Q000008:administration & dosage; D000928:Antidepressive Agents / Q000008:administration & dosage; D015331:Cohort Studies; D015897:Comorbidity; D003718:Denmark / Q000453:epidemiology; D005260:Female; D019337:Hematologic Neoplasms / Q000145:classification* / Q000175:diagnosis / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012042:Registries / Q000706:statistics & numerical data; D062707:Return to Work / Q000706:statistics & numerical data; D055815:Young Adult
D014151:Anti-Anxiety Agents; D000928:Antidepressive Agents