Association Between Baseline Patient-Reported Outcomes and Complications of Hematopoietic Stem Cell Transplantation.
Association Between Baseline Patient-Reported Outcomes and Complications of Hematopoietic Stem Cell Transplantation.
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造血干细胞移植患者报告的基线结局与并发症之间的相关性
DOI：
10.1016/j.jtct.2021.02.029
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发表时间：
2021-06
影响因子：
3.2
通讯作者：
El-Jawahri, Areej
中科院分区：
文献类型：
--
作者：
Johnson, P. Connor;Bhatt, Sunil;Reynolds, Matthew J.;Dhawale, Tejaswini M.;Ufere, Nneka;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
关键词：
造血细胞移植（HCT）是一种潜在的治疗血液系统恶性肿瘤的方法，但它往往导致显著的毒性和生活质量（QOL）下降。尽管患者报告的预后（pro）在HCT中的价值日益得到认可，但关于pro与HCT并发症之间关系的数据有限。我们对2011年至2016年在马萨诸塞州总医院因自体或同种异体HCT住院的250例患者进行了二次数据分析。我们在基线时评估了QOL（癌症治疗功能评估-一般）、情绪（医院焦虑和抑郁量表）和疲劳（FACT-Fatigue）。我们从电子健康记录中提取(1)HCT后前100天的住院情况，(2)HCT后前100天存活和出院的天数，以及(3)同种异体HCT受者急性移植物抗宿主病（GVHD）的累积发病率。我们使用多变量模型对患者和移植特征进行调整，评估了基线PROs与HCT并发症的关系。总体而言，44.4%（111/250）的患者接受了自体HCT， 25.2%（63/250）的患者接受了清髓异体HCT， 30.4%（76/250）的患者接受了低强度异体HCT。在多变量logistic回归中，较高的焦虑（比值比[OR] = 1.14, P = 0.004）与HCT后100天内再次住院的可能性较高相关。在多变量泊松回归中，较低的疲劳（β = 0.003, P = 0.015）与hct后前100天存活和出院天数增加相关。在多变量logistic回归中，较低的基线生活质量（OR = 0.97, P = 0.034）、较高的疲劳（OR = 0.95, P = 0.004）和较高的抑郁（OR = 1.15, P = 0.020）与急性GVHD的可能性增加相关。基线pro与HCT后的医疗保健利用和同种异体HCT接受者急性GVHD的风险相关。这些发现强调了移植前pro作为HCT重要预后因素的潜在效用。
Hematopoietic cell transplantation (HCT) is a potentially curative therapy for hematologic malignancies, but it often results in significant toxicities and impaired quality of life (QOL). Although the value of patient-reported outcomes (PROs) is increasingly recognized in HCT, data are limited regarding the relationship between PROs and HCT complications. We conducted a secondary data analysis of 250 patients who were hospitalized for autologous or allogeneic HCT at Massachusetts General Hospital from 2011 through 2016. We assessed QOL (Functional Assessment of Cancer Therapy−General), mood (Hospital Anxiety and Depression Scale), and fatigue (FACT-Fatigue) at baseline. We abstracted from the Electronic Health Record (1) hospitalization during the first 100 days after HCT, (2) days alive and out of the hospital in the first 100 days after HCT, and (3) cumulative incidence of acute graft-versus-host disease (GVHD) among allogeneic HCT recipients. We assessed the association of baseline PROs with HCT complications using multivariable models adjusting for patient and transplant characteristics. Overall, 44.4% (111/250) of patients underwent an autologous HCT, 25.2% (63/250) received a myeloablative allogeneic HCT, and 30.4% (76/250) underwent a reduced-intensity allogeneic HCT. In multivariable logistic regression, higher anxiety (odds ratio [OR] = 1.14, P = .004) was associated with higher likelihood of rehospitalization within 100 days after HCT. In multivariable Poisson regression, lower fatigue (β = 0.003, P = .015) was associated with increased days alive and out of the hospital in the first 100 days post-HCT. In multivariable logistic regression, lower baseline QOL (OR = 0.97, P = .034), higher fatigue (OR = 0.95, P = .004), and higher depression (OR = 1.15, P = .020) were associated with increased likelihood of acute GVHD. Baseline PROs are associated with health care utilization after HCT and risk of acute GVHD in allogeneic HCT recipients. These findings underscore the potential utility of pretransplantation PROs as important prognostic factors for HCT.
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影响因子：
3.3
作者：
ANDRYKOWSKI, MA;BRADY, MJ;HENSLEEDOWNEY, PJ
通讯作者：
HENSLEEDOWNEY, PJ
影响因子：
6.2
作者：
El-Jawahri A;Chen YB;Brazauskas R;He N;Lee SJ;Knight JM;Majhail N;Buchbinder D;Schears RM;Wirk BM;Wood WA;Ahmed I;Aljurf M;Szer J;Beattie SM;Battiwalla M;Dandoy C;Diaz MA;D'Souza A;Freytes CO;Gajewski J;Gergis U;Hashmi SK;Jakubowski A;Kamble RT;Kindwall-Keller T;Lazarus HM;Malone AK;Marks DI;Meehan K;Savani BN;Olsson RF;Rizzieri D;Steinberg A;Speckhart D;Szwajcer D;Schoemans H;Seo S;Ustun C;Atsuta Y;Dalal J;Sales-Bonfim C;Khera N;Hahn T;Saber W
通讯作者：
Saber W
影响因子：
4.8
作者：
Majhail NS;Mau LW;Denzen EM;Arneson TJ
通讯作者：
Arneson TJ
影响因子：
4.3
作者：
Lee, SJ;Loberiza, FR;Weeks, JC
通讯作者：
Weeks, JC
影响因子：
6.2
作者：
El-Jawahri AR;Vandusen HB;Traeger LN;Fishbein JN;Keenan T;Gallagher ER;Greer JA;Pirl WF;Jackson VA;Spitzer TR;Chen YB;Temel JS
通讯作者：
Temel JS