Differences in health behaviour between recipients of allogeneic haematopoietic SCT and the general population: a matched control study

Abstract

Little is known of health-relevant behaviour among long-term survivors of haematological disorders treated with haematopoietic SCT. This comparative cross-sectional multicentre study aimed (1) to explore the prevalence of selected behaviours in this group and (2) to compare them with those of the general population. Self-reported data of 376 survivors (mean age: 50.4 (s.d. = 12.8); median 7 years postallogeneic SCT (interquartile range (IQR) = 8.9; range 1-33) were compared with controls derived from the Swiss Health Survey 2007 by propensity score matching. Survivors were more physically inactive (26.8% vs 12.5%; P ⩽ 0.001) and consumed fewer portions of vegetables (⩾ 3 pieces: 10% vs 21.6%; P< 0.001), fruits (⩾ 3 pieces: 6.5% vs 10.6%; P < 0.001) and fish (31.2% vs 60.9% weekly fish dish; P < 0.001). More survivors consumed dairy products daily (92.5% vs 62.9%; P < 0.001), used sun protection regularly (94.5% vs 85.3%, P < 0.001) and had received influenza vaccinations in the past year (58.4% vs 21.5%; P < 0.001); fewer survivors smoked (13.4% vs 35.4%; P < 0.001). Survivors' weekly alcohol consumption was lower (median 1.5 servings (IQR 4) vs median 4.5 (IQR 10.3); P < 0.001). Of those taking immunosuppressants, 65.7% were non-adherent. Similar to the general population, survivors experience problems executing several health-enhancing behaviours, warranting corrective interventions.

National Institutes of Health Hematopoietic Cell Transplantation Late Effects Initiative: The Patient-Centered Outcomes Working Group Report

“…In general, adult HCT survivors’ participation in unhealthy behaviors seems equal to or lower than that of other populations, with predictors of unhealthy behaviors including younger age, less education, and lack of health insurance (138). Smoking rates are similar to matched controls (139), but significantly lower than that of siblings (7% vs. 13%) (138, 139) and population-based controls (134). One study reported that 15% of HCT survivors restart smoking against the advice of their physicians (106).…”

“…One study reported that 15% of HCT survivors restart smoking against the advice of their physicians (106). Alcohol use over the recommended 0–1 drinks per day is lower in survivors than matched controls, and lower than that of siblings (139), and weekly consumption is lower than population-based controls (134). Data on the use of sun protection are limited but reveal that survivors use sun protection more regularly than population-based controls (134).…”

“…The sole study identified reported that among adult survivors taking immunosuppressants almost two-thirds were non-adherent (134). Medication adherence post pediatric HSCT is also poorly understood.…”

“…Adult survivors are more likely to be physically inactive compared to the general population (26.8% vs 12.5%) (134), and to exercise for shorter durations when active, but have a similar BMI compared to matched controls (139). Only 5% of survivors report eating a healthy diet that is low in fat and high in fruits and vegetables (134, 139). Recent data underscore the importance of physical activity, diet and weight control given the high rates of cardiovascular disease in long-term HCT survivors (144).…”

Comorbidities, Alcohol Use Disorder, and Age Predict Outcomes after Autologous Hematopoietic Cell Transplantation for Lymphoma

“…AUD has previously been shown to contribute to medication noncompliance in various chronic illnesses [33, 34]. While suboptimal medication compliance has been observed in up to two-thirds of long-term survivors following allogeneic HCT [35], studies on patterns of medication compliance in the early post-transplant period are lacking.…”