title: 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.
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.
authors: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, Wisconsin. Electronic address: jmknight@mcw.edu.
authors: Jennifer M
authors: JM
authors: Knight
authors: Fred Hutchinson Cancer Research Center, University of Washington, Seattle, Washington.
authors: Karen L
authors: KL
authors: Syrjala
authors: Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio.
authors: Navneet S
authors: NS
authors: Majhail
authors: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, Wisconsin.
authors: Michael
authors: M
authors: Martens
authors: Mayo Clinic, Rochester, Minnesota.
authors: Jennifer
authors: J
authors: Le-Rademacher
authors: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, Wisconsin.
authors: Brent R
authors: BR
authors: Logan
authors: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, Wisconsin; Fred Hutchinson Cancer Research Center, University of Washington, Seattle, Washington.
authors: Stephanie J
authors: SJ
authors: Lee
authors: H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida.
authors: Paul B
authors: PB
authors: Jacobsen
authors: Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina.
authors: William A
authors: WA
authors: Wood
authors: H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida.
authors: Heather S L
authors: HSL
authors: Jim
authors: University of Florida, Gainesville, Florida.
authors: John R
authors: JR
authors: Wingard
authors: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, Wisconsin.
authors: Mary M
authors: MM
authors: Horowitz
authors: Spectrum Health and Michigan State University, Grand Rapids, Michigan.
authors: Muneer H
authors: MH
authors: Abidi
authors: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, Wisconsin.
authors: Mingwei
authors: M
authors: Fei
authors: The EMMES Corporation, Rockville, Maryland.
authors: Laura
authors: L
authors: Rawls
authors: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, Wisconsin.
authors: J Douglas
authors: JD
authors: Rizzo
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006086:Graft vs Host Disease / Q000209:etiology; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects / Q000592:standards*; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D000071066:Patient Reported Outcome Measures; D011379:Prognosis; D011788:Quality of Life; D020127:Recovery of Function; D012923:Social Class; D013534:Survival; D016896:Treatment Outcome; D055815:Young Adult
keywords: Hematopoietic cell transplantation; Hematopoietic recovery; Patient-reported outcomes; Quality of life; Socioeconomic status; Survival