Psycho-Social Factors Associated with Health Outcomes in Blood and Marrow Transplant Patients

Abstract

sumed alcohol while 25% regularly smoked tobacco prior to transplant. Median follow-up time was 27 months from day 100 after HSCT. The incidence of cGVHD was 59% (95% CI 48%-70%), and NRM was 31% (95% CI 23%-41%) at 2 years for the entire cohort. Having commercial insurance was the only factor associated with a lower incidence of cGVHD (HR .54; 95% CI .29-.98, P = .04). Chronic GVHD was the only factor significantly associated with survival, and OS was 78% (95% CI 67%-86%) and 33% (95% CI 13%-56%) for those without cGVHD and cGVHD, respectively (HR 3.7; 95% CI 1.70-8.07, P = .001). Causes of death occurring after day 100 included infection (n = 15), aGVHD (n = 2), cGVHD (n = 1), organ failure (n = 4), relapse (n = 10), and unknown (n = 4). Conclusion: Our preliminary data mirrors previous reports of a lack of association between geographic distance and most SEF with cGVHD and survival. These findings may be related to the high degree of socioeconomic and educational selection prior to transplantation. The reason for a lower incidence of cGVHD in patients with commercial insurance versus Medicare/Medicaid is unclear. Ongoing accrual into the study may help further clarify this association.