Return to Work Among Young Adult Survivors of Allogeneic Hematopoietic Cell Transplantation in the United States

Neel S Bhatt; Ruta Brazauskas; Rachel B Salit; Karen Syrjala; Stephanie Bo-Subait; Heather Tecca; Sherif M Badawy; K. Scott Baker; Amer Beitinjaneh; Nelli Bejanyan; Michael Byrne; Ajoy Dias; Nosha Farhadfar; César O Freytes; Siddhartha Ganguly; Shahrukh Hashmi; Robert J Hayashi; Sanghee Hong; Yoshihiro Inamoto; Kareem Jamani; Kimberly A Kasow; Nandita Khera; Maxwell M Krem; Hillard M Lazarus; Catherine J Lee; Stephanie Lee; Navneet S Majhail; Adriana K Malone; David I Marks; Lih-Wen Mau; Samantha J Mayo; Lori S Muffly; Sunita Nathan; Taiga Nishihori; Kristin M Page; Jaime Preussler; Hemalatha G Rangarajan; Seth J Rotz; Nina Salooja; Bipin N Savani; Raquel Schears; Tal Schechter-Finkelstein; Gary Schiller; Ami J Shah; Akshay Sharma; Trent Wang; Baldeep Wirk; Minoo Battiwalla; Hélène Schoemans; Betty Hamilton; David Buchbinder; Rachel Phelan; Bronwen Shaw

doi:10.1016/j.jtct.2021.04.013

Journal article

Return to Work Among Young Adult Survivors of Allogeneic Hematopoietic Cell Transplantation in the United States

Neel S Bhatt, Ruta Brazauskas, Rachel B Salit, Karen Syrjala, Stephanie Bo-Subait, Heather Tecca, Sherif M Badawy, K. Scott Baker, Amer Beitinjaneh, Nelli Bejanyan, …

Transplantation and cellular therapy

2021-04-22

DOI: https://doi.org/10.1016/j.jtct.2021.04.013

PMID: 33895402

Abstract

Hematopoietic cell transplantation

Young adult

Return to work

Quality of life

•Nearly 40% of young adult hematopoietic cell transplantation (HCT) survivors were out of work at 3 years post-HCT.•Of those in full-time work pre-HCT, 50% were not working at 1 year post-HCT.•Myeloablative conditioning with total body irradiation was associated with a greater likelihood of unemployment at 1 year post-HCT. Young adult (YA) survivors of allogeneic hematopoietic cell transplantation (HCT) are at risk for late psychosocial challenges, including the inability to return to work post-HCT. Work-related outcomes in this population remain understudied, however. We conducted this study to assess the post-HCT work status of survivors of allogeneic HCT who underwent HCT as YAs and to analyze the patient-, disease-, and HCT-related factors associated with their work status at 1 year post-HCT. Using Center for International Blood and Marrow Transplant Research data, we evaluated the post-HCT work status (full-time, part-time work, unemployed, or medical disability) of 1365 YA HCT survivors who underwent HCT between 2008 and 2015. Percentages of work status categories were reported at 4 time points: 6 months, 1 year, 2 years, and 3 years post-HCT. Percentages of post-HCT work status categories at the 1-year time point were also described in relation to survivors’ pre-HCT work status categories. Factors associated with 1-year post-HCT work status (full-time or part-time work) were examined using logistic regression. From 6 months to 3 years post-HCT, the percentage of survivors working full-time increased from 18.3% to 50.7% and the percentage working part-time increased from 6.9% to 10.5%. Of patients in full-time work pre-HCT, 50% were unemployed or on medical disability at 1 year post-HCT. Female sex (odds ratio [OR], 0.55; 95% confidence interval [CI], 0.40 to 0.77), HCT Comorbidity Index score ≥3 (OR, 0.57; 95% CI, 0.39 to 0.82), pre-HCT unemployment (OR, 0.37; 95% CI, 0.24 to 0.56), medical disability (OR, 0.44; 95% CI, 0.28 to 0.70), development of grade III-IV acute graft-versus-host disease (OR, 0.52; 95% CI, 0.34 to 0.80), and relapse within 1 year post-HCT (OR, 0.34; 95% CI, 0.21 to 0.56) were associated with a lower likelihood of employment at 1 year post-HCT. Compared with myeloablative conditioning (MAC) with total body irradiation (TBI), MAC without TBI (OR, 1.71; 95% CI, 1.16 to 2.53) was associated with a greater likelihood of employment at 1 year post-HCT. Graduate school-level education (OR, 2.47; 95% CI, 1.49 to 4.10) was also associated with a greater likelihood of employment at 1 year post-HCT. Although the work status among YA HCT survivors continued to improve over time, a substantial subset became or remained unemployed or on medical disability. These findings underscore the need for effective interventions to support return to work in this population.

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Collaboration types: Industry collaboration; Domestic collaboration; International collaboration
Citation topics: 1 Clinical & Life Sciences; 1.112 Palliative Care; 1.112.1459 Childhood Cancer
Web Of Science research areas: Hematology; Immunology; Transplantation
ESI research areas: Immunology

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Details

Title: Return to Work Among Young Adult Survivors of Allogeneic Hematopoietic Cell Transplantation in the United States
Creators: Neel S Bhatt - Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
Ruta Brazauskas - Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
Rachel B Salit - Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
Karen Syrjala - Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
Stephanie Bo-Subait - Center for International Blood and Marrow Transplant Research), National Marrow Donor Program/Be The Match, Minneapolis, Minnesota
Heather Tecca - Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
Sherif M Badawy - Division of Hematology, Oncology and Stem Cell Transplant, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
K. Scott Baker - Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
Amer Beitinjaneh - Division of Transplantation and Cellular Therapy, University of Miami, Miami, Florida
Nelli Bejanyan - Department of Blood and Marrow Transplant and Cellular Immunotherapy, Moffitt Cancer Center, Tampa, Florida
Michael Byrne - Vanderbilt University Medical Center, Nashville, Tennessee
Ajoy Dias - Beth Israel Deaconess Medical Center, Boston, Massachusetts
Nosha Farhadfar - Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, Florida
César O Freytes - Texas Transplant Institute, San Antonio, Texas
Siddhartha Ganguly - Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, Kansas
Shahrukh Hashmi - Department of Internal Medicine, Mayo Clinic, Minnesota
Robert J Hayashi - Division of Pediatric Hematology/Oncology, Department of Pediatrics, Washington University School of Medicine in St Louis, St Louis, Missouri
Sanghee Hong - Blood and Marrow Transplant Program, Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio
Yoshihiro Inamoto - Division of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan
Kareem Jamani - Tom Baker Cancer Centre, University of Calgary, Calgary, Alberta, Canada
Kimberly A Kasow - University of North Carolina, Chapel Hill, North Carolina
Nandita Khera - Department of Hematology/Oncology, Mayo Clinic, Phoenix, Arizona
Maxwell M Krem - Markey Cancer Center, University of Kentucky College of Medicine, Lexington, Kentucky
Hillard M Lazarus - University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio
Catherine J Lee - Utah Blood and Marrow Transplant Program at Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah
Stephanie Lee - Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
Navneet S Majhail - Blood and Marrow Transplant Program, Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio
Adriana K Malone - Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, New York
David I Marks - Adult Bone Marrow Transplant, University Hospitals Bristol NHS Trust, Bristol, United Kingdom
Lih-Wen Mau - Center for International Blood and Marrow Transplant Research), National Marrow Donor Program/Be The Match, Minneapolis, Minnesota
Samantha J Mayo - Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
Lori S Muffly - Division of Blood and Marrow Transplantation, Stanford University, Stanford, California
Sunita Nathan - Section of Bone Marrow Transplant and Cell Therapy, Rush University Medical Center, Chicago, Illinois
Taiga Nishihori - Department of Blood and Marrow Transplant and Cellular Immunotherapy, Moffitt Cancer Center, Tampa, Florida
Kristin M Page - Division of Pediatric Blood and Marrow Transplantation, Duke University Medical Center, Durham, North Carolina
Jaime Preussler - Center for International Blood and Marrow Transplant Research), National Marrow Donor Program/Be The Match, Minneapolis, Minnesota
Hemalatha G Rangarajan - Department of Pediatric Hematology, Oncology, Blood and Marrow Transplantation, Nationwide Children's hospital, Columbus, Ohio
Seth J Rotz - Department of Pediatric Hematology, Oncology, and Blood and Marrow Transplantation, Cleveland Clinic Children's Hospital, Cleveland, Ohio
Nina Salooja - Imperial College London, London, United Kingdom
Bipin N Savani - Division of Hematology/Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
Raquel Schears - University of Central Florida, Department of Emergency Medicine, Orlando, Florida
Tal Schechter-Finkelstein - Hospital for Sick Children, Toronto, Ontario Canada
Gary Schiller - Hematological Malignancy/Stem Cell Transplant Program, David Geffen School of Medicine at UCLA, Los Angeles, California
Ami J Shah - Division of Stem Cell Transplantation and Regenerative Medicine, Lucille Packard Children's Hospital, Stanford School of Medicine, Palo Alto, California
Akshay Sharma - Department of Bone Marrow Transplantation and Cellular Therapy, St. Jude Children's Research Hospital, Memphis, Tennessee
Trent Wang - Division of Transplantation and Cellular Therapy, University of Miami, Miami, Florida
Baldeep Wirk - Penn State Cancer Institute, Bone Marrow Transplant Program, Hershey, Pennsylvania
Minoo Battiwalla - Sarah Cannon Blood Cancer Network, Nashville, Tennessee
Hélène Schoemans - Department of Hematology, University Hospitals Leuven and KU Leuven, Leuven, Belgium
Betty Hamilton - Blood and Marrow Transplant Program, Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio
David Buchbinder - Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, California
Rachel Phelan - Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
Bronwen Shaw - Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
Publication Details: Transplantation and cellular therapy
Publisher: Elsevier Inc
Academic Unit: Miller School of Medicine; UMMG Dept of Medicine - Hematology/Oncology
Language: English
Resource Type: Journal article
PMID: 33895402
Record Identifier: 991031597909402976