J Tay1, S Beattie1, C Bredeson2, R Brazauskas3, N He3, I A Ahmed3, M Aljurf4, M Askar3, Y Atsuta5, S Badawy3, A Barata6, A M Beitinjaneh3, N S Bhatt3, D Buchbinder3, J Cerny3, S Ciurea3, A D'Souza3, J Dalal3, N Farhadfar3, C O Freytes3, S Ganguly3, U Gergis3, S Gerull7, H M Lazarus3, T Hahn3, S Hong3, Y Inamoto5, N Khera3, T Kindwall-Keller3, R T Kamble3, J M Knight3, Y N Koleva3, A Kumar3, J Kwok8, H S Murthy3, R F Olsson9, M Angel Diaz-Perez6, D Rizzieri3, S Seo5, S Chhabra3, H Schoemans10, H C Schouten11, A Steinberg3, K M Sullivan5, J Szer12, D Szwajcer13, M L Ulrickson3, L F Verdonck11, B Wirk3, W A Wood3, J A Yared3, W Saber3. 1. Alberta: Tom Baker Cancer Centre, University of Calgary, Calgary (Tay, Beattie). 2. Ontario: The Ottawa Hospital Blood and Marrow Transplant Program and The Ottawa Hospital Research Institute, Ottawa (Bredeson). 3. U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared). 4. Saudi Arabia: Department of Oncology, King Faisal Specialist Hospital Center and Research, Riyadh (Aljurf). 5. Japan: Japanese Data Center for Hematopoietic Cell Transplantation, Nagoya (Atsuta); Nagoya University Graduate School of Medicine, Nagoya (Atsuta); Division of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo (Inamoto); Department of Hematology and Oncology, Dokkyo Medical University, Tochigi (Seo, Sullivan). 6. Spain: Hospital de la Santa Creu i Sant Pau, Barcelona (Barata); Department of Hematology/Oncology, Hospital Infantil Universitario Nino Jesus, Madrid (Angel Diaz-Perez). 7. Switzerland: Department of Hematology, University Hospital, Basel (Gerull). 8. P.R.C.: Division of Transplantation and Immunogenetics, Department of Pathology, Queen Mary Hospital, Hong Kong sar (Kwok). 9. Sweden: Department of Laboratory Medicine, Karolinska Institutet, Stockholm (Olsson); Centre for Clinical Research Sormland, Uppsala University, Uppsala (Olsson). 10. Belgium: University Hospital Leuven and KU Leuven, Leuven (Schoemans). 11. Netherlands: Department of Hematology, Acadeische Ziekenhuis, Maastrict (Schouten); Department of Hematology/Oncology, Isala Clinic, Zwolle (Verdonck). 12. Australia: Clinical Haematology, Peter MacCallum Cancer Centre and The Royal Melbourne Hospital, Victoria (Szer). 13. Manitoba: CancerCare Manitoba, Winnipeg, MB (Szwajcer).
Abstract
Background: Evidence about the impact of marital status before hematopoietic cell transplantation (hct) on outcomes after hct is conflicting. Methods: We identified patients 40 years of age and older within the Center for International Blood and Marrow Transplant Research registry who underwent hct between January 2008 and December 2015. Marital status before hct was declared as one of: married or living with a partner, single (never married), separated or divorced, and widowed. We performed a multivariable analysis to determine the association of marital status with outcomes after hct. Results: We identified 10,226 allogeneic and 5714 autologous hct cases with, respectively, a median follow-up of 37 months (range: 1-102 months) and 40 months (range: 1-106 months). No association between marital status and overall survival was observed in either the allogeneic (p = 0.58) or autologous (p = 0.17) setting. However, marital status was associated with grades 2-4 acute graft-versus-host disease (gvhd), p < 0.001, and chronic gvhd, p = 0.04. The risk of grades 2-4 acute gvhd was increased in separated compared with married patients [hazard ratio (hr): 1.13; 95% confidence interval (ci): 1.03 to 1.24], and single patients had a reduced risk of grades 2-4 acute gvhd (hr: 0.87; 95% ci: 0.77 to 0.98). The risk of chronic gvhd was lower in widowed compared with married patients (hr: 0.82; 95% ci: 0.67 to 0.99). Conclusions: Overall survival after hct is not influenced by marital status, but associations were evident between marital status and grades 2-4 acute and chronic gvhd. To better appreciate the effects of marital status and social support, future research should consider using validated scales to measure social support and patient and caregiver reports of caregiver commitment, and to assess health-related quality of life together with health care utilization. 2020 Multimed Inc.
Background: Evidence about the impact of marital status before hematopoietic cell transplantation (hct) on outcomes after hct is conflicting. Methods: We identified patients 40 years of age and older within the Center for International Blood and Marrow Transplant Research registry who underwent hct between January 2008 and December 2015. Marital status before hct was declared as one of: married or living with a partner, single (never married), separated or divorced, and widowed. We performed a multivariable analysis to determine the association of marital status with outcomes after hct. Results: We identified 10,226 allogeneic and 5714 autologous hct cases with, respectively, a median follow-up of 37 months (range: 1-102 months) and 40 months (range: 1-106 months). No association between marital status and overall survival was observed in either the allogeneic (p = 0.58) or autologous (p = 0.17) setting. However, marital status was associated with grades 2-4 acute graft-versus-host disease (gvhd), p < 0.001, and chronic gvhd, p = 0.04. The risk of grades 2-4 acute gvhd was increased in separated compared with married patients [hazard ratio (hr): 1.13; 95% confidence interval (ci): 1.03 to 1.24], and single patients had a reduced risk of grades 2-4 acute gvhd (hr: 0.87; 95% ci: 0.77 to 0.98). The risk of chronic gvhd was lower in widowed compared with married patients (hr: 0.82; 95% ci: 0.67 to 0.99). Conclusions: Overall survival after hct is not influenced by marital status, but associations were evident between marital status and grades 2-4 acute and chronic gvhd. To better appreciate the effects of marital status and social support, future research should consider using validated scales to measure social support and patient and caregiver reports of caregiver commitment, and to assess health-related quality of life together with health care utilization. 2020 Multimed Inc.
Authors: Areej El-Jawahri; Yi-Bin Chen; Ruta Brazauskas; Naya He; Stephanie J Lee; Jennifer M Knight; Navneet Majhail; David Buchbinder; Raquel M Schears; Baldeep M Wirk; William A Wood; Ibrahim Ahmed; Mahmoud Aljurf; Jeff Szer; Sara M Beattie; Minoo Battiwalla; Christopher Dandoy; Miguel-Angel Diaz; Anita D'Souza; Cesar O Freytes; James Gajewski; Usama Gergis; Shahrukh K Hashmi; Ann Jakubowski; Rammurti T Kamble; Tamila Kindwall-Keller; Hilard M Lazarus; Adriana K Malone; David I Marks; Kenneth Meehan; Bipin N Savani; Richard F Olsson; David Rizzieri; Amir Steinberg; Dawn Speckhart; David Szwajcer; Helene Schoemans; Sachiko Seo; Celalettin Ustun; Yoshiko Atsuta; Jignesh Dalal; Carmem Sales-Bonfim; Nandita Khera; Theresa Hahn; Wael Saber Journal: Cancer Date: 2017-01-19 Impact factor: 6.860
Authors: Sara Beattie; Sophie Lebel; Danielle Petricone-Westwood; Keith G Wilson; Cheryl Harris; Gerald Devins; Lothar Huebsch; Jason Tay Journal: Psychooncology Date: 2017-02-02 Impact factor: 3.894
Authors: D Przepiorka; D Weisdorf; P Martin; H G Klingemann; P Beatty; J Hows; E D Thomas Journal: Bone Marrow Transplant Date: 1995-06 Impact factor: 5.483
Authors: Anita D'Souza; Caitrin Fretham; Stephanie J Lee; Mukta Arora; Janet Brunner; Saurabh Chhabra; Steven Devine; Mary Eapen; Mehdi Hamadani; Parameswaran Hari; Marcelo C Pasquini; Waleska Perez; Rachel A Phelan; Marcie L Riches; J Douglas Rizzo; Wael Saber; Bronwen E Shaw; Stephen R Spellman; Patricia Steinert; Daniel J Weisdorf; Mary M Horowitz Journal: Biol Blood Marrow Transplant Date: 2020-05-11 Impact factor: 5.609