| Literature DB >> 33895402 |
Neel S Bhatt1, Ruta Brazauskas2, Rachel B Salit3, Karen Syrjala3, Stephanie Bo-Subait4, Heather Tecca5, Sherif M Badawy6, K Scott Baker3, Amer Beitinjaneh7, Nelli Bejanyan8, Michael Byrne9, Ajoy Dias10, Nosha Farhadfar11, César O Freytes12, Siddhartha Ganguly13, Shahrukh Hashmi14, Robert J Hayashi15, Sanghee Hong16, Yoshihiro Inamoto17, Kareem Jamani18, Kimberly A Kasow19, Nandita Khera20, Maxwell M Krem21, Hillard M Lazarus22, Catherine J Lee23, Stephanie Lee24, Navneet S Majhail16, Adriana K Malone25, David I Marks26, Lih-Wen Mau4, Samantha J Mayo27, Lori S Muffly28, Sunita Nathan29, Taiga Nishihori8, Kristin M Page30, Jaime Preussler4, Hemalatha G Rangarajan31, Seth J Rotz32, Nina Salooja33, Bipin N Savani34, Raquel Schears35, Tal Schechter-Finkelstein36, Gary Schiller37, Ami J Shah38, Akshay Sharma39, Trent Wang7, Baldeep Wirk40, Minoo Battiwalla41, Hélène Schoemans42, Betty Hamilton16, David Buchbinder43, Rachel Phelan5, Bronwen Shaw5.
Abstract
Young adult (YA) survivors of allogeneic hematopoietic cell transplantation (HCT) are at risk for late psychosocial challenges, including the inability to return to work post-HCT. Work-related outcomes in this population remain understudied, however. We conducted this study to assess the post-HCT work status of survivors of allogeneic HCT who underwent HCT as YAs and to analyze the patient-, disease-, and HCT-related factors associated with their work status at 1 year post-HCT. Using Center for International Blood and Marrow Transplant Research data, we evaluated the post-HCT work status (full-time, part-time work, unemployed, or medical disability) of 1365 YA HCT survivors who underwent HCT between 2008 and 2015. Percentages of work status categories were reported at 4 time points: 6 months, 1 year, 2 years, and 3 years post-HCT. Percentages of post-HCT work status categories at the 1-year time point were also described in relation to survivors' pre-HCT work status categories. Factors associated with 1-year post-HCT work status (full-time or part-time work) were examined using logistic regression. From 6 months to 3 years post-HCT, the percentage of survivors working full-time increased from 18.3% to 50.7% and the percentage working part-time increased from 6.9% to 10.5%. Of patients in full-time work pre-HCT, 50% were unemployed or on medical disability at 1 year post-HCT. Female sex (odds ratio [OR], 0.55; 95% confidence interval [CI], 0.40 to 0.77), HCT Comorbidity Index score ≥3 (OR, 0.57; 95% CI, 0.39 to 0.82), pre-HCT unemployment (OR, 0.37; 95% CI, 0.24 to 0.56), medical disability (OR, 0.44; 95% CI, 0.28 to 0.70), development of grade III-IV acute graft-versus-host disease (OR, 0.52; 95% CI, 0.34 to 0.80), and relapse within 1 year post-HCT (OR, 0.34; 95% CI, 0.21 to 0.56) were associated with a lower likelihood of employment at 1 year post-HCT. Compared with myeloablative conditioning (MAC) with total body irradiation (TBI), MAC without TBI (OR, 1.71; 95% CI, 1.16 to 2.53) was associated with a greater likelihood of employment at 1 year post-HCT. Graduate school-level education (OR, 2.47; 95% CI, 1.49 to 4.10) was also associated with a greater likelihood of employment at 1 year post-HCT. Although the work status among YA HCT survivors continued to improve over time, a substantial subset became or remained unemployed or on medical disability. These findings underscore the need for effective interventions to support return to work in this population.Entities:
Keywords: Hematopoietic cell transplantation; Quality of life; Return to work; Young adult
Mesh：
Year: 2021 PMID： 33895402 PMCID： PMC8425287 DOI： 10.1016/j.jtct.2021.04.013
Source DB: PubMed Journal: Transplant Cell Ther ISSN： 2666-6367