Impact of marital status during diagnosis on cancer-caused specific survival in acute myeloid leukemia patients: a case-control and population-based study

Abstract

ObjectiveThis study investigated the impact of marital status on cancer-caused specific mortality among acute myeloid leukemia (AML) patients in the United States.MethodsWe used the Surveillance, Epidemiology and End Results program to identify 50,825 patients who had their clinical and follow-up information available and were diagnosed for AML between the years 1988 and 2015. The univariate and multivariable Cox regression models were used to analyze the patient data, and to minimize the group differences due to covariates between groups, a 1:1 propensity score matching was used in subsequent subgroup analysis.ResultsOur study demonstrated that married patients were less likely to die due to AML after adjusting for demographic and clinicopathological variables, than patients with variable unmarried status. Further analysis indicated that widowed, divorced and never married status correlated with poor cancer-cause specific survival than being married in almost all subgroups after being adjusted for the aforementioned variables (P<0.05). However, the difference between married and separated was not apparent. Moreover, similar survival analysis results were also observed in the 1:1 matched subgroups of marital status, but they displayed varied prognostic factors between them. The association of survival benefit with marriage in AML was consistent with the published survival benefit of conventional therapeutic approaches.ConclusionOverall, our study concluded that unmarried AML patients were at greater risk of cancer-specific mortality than married, and thus indicated that physicians should focus on health care strategies that target social support, in order to reduce the cancer-specific mortality in unmarried patients.

The global burden and attributable risk factor analysis of acute myeloid leukemia in 195 countries and territories from 1990 to 2017: estimates based on the global burden of disease study 2017

“…Consistent with the data of solid tumors, marital status is closely associated to the risk of AML-related death. Compared with unmarried AML patients, married or cohabitating counterparts had a lower risk of death [27,39]. In terms of socioeconomic status, the prognosis of AML's patients with low-income or residing in poverty-stricken regions was relatively poorer [3,40].…”

Cumulative Deficits Frailty Index and Relationship Status Predict Survival in Multiple Myeloma

“…However, the independent prognostic value of these factors has not been consistent across studies. [24][25][26][27][28][29] Our study also examines the association between these factors and disease/symptom burden and survival in patients with MM. While most studies use neighborhood characteristics to estimate SES, this study utilizes the HOUSES index, a measure derived from individual housing characteristics.…”

Does marital status affect the outcomes after allogeneic hematopoietic cell transplantation?

“…Marital status has been reported to be associated with survival in patients with several types of cancer, including acute myeloid leukemia, and those receiving solid organ transplantation [1][2][3][4][5]. However, there have been no reports detailing the impact of marital status on outcomes after allogeneic hematopoietic cell transplantation (HCT).…”

“…Several studies have shown that marital status affected cancer-specific mortality among patients with solid cancer and acute myeloid leukemia [1][2][3][4], whereas other studies have not [9]. The reason for the correlation of marital status and improved cancer-specific survival has been unclear, but one possible reason is that married patients have better adherence to prescribed treatments than unmarried patients [10].…”