Association Between Baseline Patient-Reported Outcomes and Complications of Hematopoietic Stem Cell Transplantation

Johnson, Patrick Connor; Bhatt, Sunil; Reynolds, Matthew J.; Dhawale, Tejaswini; Ufere, Nneka N.; Jagielo, Annemarie D.; Lavoie, Mitchell W.; Topping, Carlisle E.W.; Clay, Madison A.; Rice, Julia; Yi, Alisha; DeFilipp, Zachariah; Chen, Yi Bin; El‐Jawahri, Areej

doi:10.1016/j.jtct.2021.02.029

Cited by 9 publications

(9 citation statements)

References 45 publications

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“…Evidence from a secondary analysis of cancer trials suggests consistency in correlations ranging from 0.4 to 0.6 15 . Additionally, results align with previous research in alloHCT, where baseline physical function significantly predicted survival outcomes 16 and lower baseline QOL, higher fatigue, and higher depression were associated with increased risk of acute GVHD 17 . Baseline and 6‐month PRO scores were the strongest predictors of later PRO scores, but we found no associations of PROs with AML transformation, relapse, or acute or chronic GVHD.…”

Section: Discussionsupporting

confidence: 81%

“…15 Additionally, results align with previous research in alloHCT, where baseline physical function significantly predicted survival outcomes 16 and lower baseline QOL, higher fatigue, and higher depression were associated with increased risk of acute GVHD. 17 Baseline and 6-month PRO scores were the strongest predictors of later PRO scores, but we found no associations of PROs with AML transformation, relapse, or acute or chronic GVHD. Together, these findings illustrate the importance of adding pre-transplant QOL to the list of clinical factors to consider when assessing eligibility for transplantation.…”

Section: Discussioncontrasting

confidence: 74%

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Health‐related quality of life in reduced‐intensity hematopoietic cell transplantation based on donor availability in patients aged 50–75 with advanced myelodysplastic syndrome: BMT CTN 1102

et al. 2022

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For myelodysplastic syndrome (MDS), allogeneic hematopoietic cell transplantation (alloHCT) is the only available curative therapy. The Blood and Marrow Transplant Clinical Trials Network study 1102 (BMT CTN 1102, NCT02016781) was a multicenter, biologic assignment trial based on matched donor availability in adults aged 50-75 with higher risk de novo MDS who were candidates for reduced-intensity conditioning (RIC) alloHCT. The primary analysis showed that those who received alloHCT had a survival benefit, but whether this is at the cost of worse quality of life (QOL) has not been described in detail. English-and Spanish-speaking trial participants completed the Functional Assessment of Cancer Therapy-General (FACT-G), the SF-36, and the EQ-5D, at enrollment, every 6 months until 24 months, and 36 months. We compared patient-reported outcome (PRO) scores between study arms using an inverse probability weighted-independent estimating equation (IPW-IEE) model.

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Section: Discussionsupporting

confidence: 81%

Section: Discussioncontrasting

confidence: 74%

Health‐related quality of life in reduced‐intensity hematopoietic cell transplantation based on donor availability in patients aged 50–75 with advanced myelodysplastic syndrome: BMT CTN 1102

et al. 2022

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“…Seventy-one percent of centers objectively measured physical strength and function. Patient- and clinician-reported outcome measures enable a global assessment of a patient’s physical function status and are increasingly being incorporated into oncologic practice 40-42. Approximately, 93% of centers cited administering a clinician- or patient-reported outcome measure during hospitalization.…”

Section: Discussionmentioning

confidence: 99%

Assessment of Rehabilitation Practices During Hematopoietic Stem Cell Transplantation in the United States: A Survey

Leite,

Oza,

Parke

et al. 2024

Rehabilitation Oncology

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Background: Rehabilitation therapy is important to treat physical and functional impairments that may occur in individuals receiving physically taxing, yet potentially curative hematopoietic stem cell transplants (HSCTs). However, there are scarce data on how rehabilitation is delivered during HSCT in real-life setting. Our objective is to assess the rehabilitation practices for adult patients hospitalized for HSCT in the United States. Methods: We conducted a 48-question online survey with cancer centers with the top 10% HSCT volumes (per American registries). We obtained data on patient characteristics, rehabilitation therapy details (timing, indication, and administering providers), physical function objective and subjective outcome measures, and therapy activity precautions. Results: Out of 21 institutions, 14 were included. Rehabilitation therapy referrals occurred at admission for all patients at 35.7% of the centers for: functional decline (92.9%), fall risk (71.4%), and discharge planning (71.4%). Participating institutions had physical therapists (92.9%), occupational therapists (85.7%), speech-language pathologists (64.3%), and therapy aides (35.7%) in their rehabilitation team. Approximately 71% of centers used objective functional measures including sit-to-stand tests (50.0%), balance measures (42.9%), and 6-minute walk/gait speed (both 35.7%). Monitoring of blood counts to determine therapy modalities frequently occurred and therapies held for low platelet or hemoglobin values, but absolute neutrophil values were not a barrier to participate in resistance or aerobic therapies (42.9%). Conclusion: Rehabilitation practices during HSCT varied among the largest volume cancer centers in the United States, but most centers provided skilled therapy, utilized objective, clinician- and patient-reported outcomes, and monitored blood counts for safety of therapy administration.

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“…Previous studies, while limited by substantial heterogeneity in patient populations and survey-based inventories, suggest that well-being reaches its nadir 1-2 weeks after SCT before recovering in subsequent months [ 5 , 11 - 16 ]. Even so, long-term consequences of these short-term exacerbations may include persistent decreases in QOL, lowered posttransplant medication adherence, psychological comorbidities, reliance on potentially inappropriate medications such as benzodiazepines, and increased risk of hospital readmissions [ 17 - 23 ]. Several hospital-based interventions have thus been studied to target well-being during SCT, such as scheduled palliative care consultations, structured exercise programs, acupuncture, music therapy, and programmed room lighting [ 24 - 29 ].…”

Section: Introductionmentioning

confidence: 99%

Digital Life Coaching During Stem Cell Transplantation: Development and Usability Study

Banerjee¹,

Huang²,

Dunn³

et al. 2022

JMIR Form Res

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Background For patients with multiple myeloma receiving high-dose chemotherapy followed by autologous stem cell transplantation (SCT), acute life disruptions and symptom burden may lead to worsened quality of life (QOL) and increased emotional distress. Digital life coaching (DLC), whereby trained coaches deliver personalized well-being–related support via phone calls and SMS text messaging, has been shown to improve QOL among SCT survivors. However, DLC has not been investigated during the acute peri-SCT period, which is generally characterized by symptomatic exacerbations and 2-week hospitalizations. Objective We launched a single-arm pilot study to investigate the feasibility of patient engagement with DLC during this intensive period. Methods We approached English-speaking adult patients with multiple myeloma undergoing autologous SCT at our center. Enrolled patients received 16 weeks of virtual access to a life coach beginning on day −5 before SCT. Coaches used structured frameworks to help patients identify and overcome personal barriers to well-being. Patients chose the coaching topics and preferred communication styles. Our primary endpoint was ongoing DLC engagement, defined as bidirectional conversations occurring at least once every 4 weeks during the study period. Secondary endpoints were electronic patient-reported outcome assessments of QOL, distress, and sleep disturbances. Results Of the 20 patients who were screened, 17 (85%) chose to enroll and 15 (75%) underwent SCT as planned. Of these 15 patients (median age 65 years, range 50-81 years), 11 (73%) demonstrated ongoing DLC engagement. The median frequency of bidirectional conversations during the 3-month study period was once every 6.2 days (range 3.9-28 days). During index hospitalizations with median lengths of stay of 16 days (range 14-31 days), the median frequency of conversations was once every 5.3 days (range 2.7-15 days). Electronic patient-reported outcome assessments (94% adherence) demonstrated an expected QOL nadir during the second week after SCT. The prevalence of elevated distress was highest immediately before and after SCT, with 69% of patients exhibiting elevated distress on day −5 and on day +2. Conclusions DLC may be feasible for older patients during intensive hospital-based cancer treatments such as autologous SCT for multiple myeloma. The limitations of our study include small sample size, selection bias among enrolled patients, and heterogeneity in DLC use. Based on the positive results of this pilot study, a larger phase 2 randomized study of DLC during SCT is underway to investigate the efficacy of DLC with regard to patient well-being. Trial Registration ClinicalTrials.gov NCT04432818; https://clinicaltrials.gov/ct2/show/NCT04432818.

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Association Between Baseline Patient-Reported Outcomes and Complications of Hematopoietic Stem Cell Transplantation

Cited by 9 publications

References 45 publications

Health‐related quality of life in reduced‐intensity hematopoietic cell transplantation based on donor availability in patients aged 50–75 with advanced myelodysplastic syndrome: BMT CTN 1102

Health‐related quality of life in reduced‐intensity hematopoietic cell transplantation based on donor availability in patients aged 50–75 with advanced myelodysplastic syndrome: BMT CTN 1102

Assessment of Rehabilitation Practices During Hematopoietic Stem Cell Transplantation in the United States: A Survey

Digital Life Coaching During Stem Cell Transplantation: Development and Usability Study

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