Predictors of Loss to Follow-Up Among Pediatric and Adult Hematopoietic Cell Transplantation Survivors: A Report from the Center for International Blood and Marrow Transplant Research

David Buchbinder*, Ruta Brazauskas, Khalid Bo-Subait, Karen Ballen, Susan Parsons, Tami John, Theresa Hahn, Akshay Sharma, Amir Steinberg, Anita D'Souza, Anita J. Kumar, Ayami Yoshimi, Baldeep Wirk, Bronwen Shaw, César Freytes, Charles LeMaistre, Christopher Bredeson, Christopher Dandoy, David Almaguer, David I. MarksDavid Szwajcer, Gregory Hale, Harry Schouten, Hasan Hashem, Hélène Schoemans, Hemant S. Murthy, Hillard M. Lazarus, Jan Cerny, Jason Tay, Jean A. Yared, Kehinde Adekola, Kirk R. Schultz, Leslie Lehmann, Linda Burns, Mahmoud Aljurf, Miguel Angel Diaz, Navneet Majhail, Nosha Farhadfar, Rammurti Kamble, Richard Olsson, Raquel Schears, Sachiko Seo, Sara Beattie, Saurabh Chhabra, Bipin N. Savani, Sherif Badawy, Siddhartha Ganguly, Stefan Ciurea, Susana Marino, Usama Gergis, Yachiyo Kuwatsuka, Yoshihiro Inamoto, Nandita Khera, Shahrukh Hashmi, William Wood, Wael Saber

*Corresponding author for this work

Research output: Contribution to journalArticle

Abstract

Follow-up is integral for hematopoietic cell transplantation (HCT) care to ensure surveillance and intervention for complications. We characterized the incidence of and predictors for being lost to follow-up. Two-year survivors of first allogeneic HCT (10,367 adults and 3865 children) or autologous HCT (7291 adults and 467 children) for malignant/nonmalignant disorders between 2002 and 2013 reported to the Center for International Blood and Marrow Transplant Research were selected. The cumulative incidence of being lost to follow-up (defined as having missed 2 consecutive follow-up reporting periods) was calculated. Marginal Cox models (adjusted for center effect) were fit to evaluate predictors. The 10-year cumulative incidence of being lost to follow-up was 13% (95% confidence interval [CI], 12% to 14%) in adult allogeneic HCT survivors, 15% (95% CI, 14% to 16%) in adult autologous HCT survivors, 25% (95% CI, 24% to 27%) in pediatric allogeneic HCT survivors, and 24% (95% CI, 20% to 29%) in pediatric autologous HCT survivors. Factors associated with being lost to follow-up include younger age, nonmalignant disease, public/no insurance (reference: private), residence farther from the tranplantation center, and being unmarried in adult allogeneic HCT survivors; older age and testicular/germ cell tumor (reference: non-Hodgkin lymphoma) in adult autologous HCT survivors; older age, public/no insurance (reference: private), and nonmalignant disease in pediatric allogeneic HCT survivors; and older age in pediatric autologous HCT survivors. Follow-up focusing on minimizing attrition in high-risk groups is needed to ensure surveillance for late effects.

Original languageEnglish (US)
Pages (from-to)553-561
Number of pages9
JournalBiology of Blood and Marrow Transplantation
Volume26
Issue number3
DOIs
StatePublished - Mar 2020

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Keywords

  • Bone marrow transplantation
  • Lost to follow-up
  • Stem cell transplantation
  • Survivor

ASJC Scopus subject areas

  • Hematology
  • Transplantation

Cite this

Buchbinder, D., Brazauskas, R., Bo-Subait, K., Ballen, K., Parsons, S., John, T., Hahn, T., Sharma, A., Steinberg, A., D'Souza, A., Kumar, A. J., Yoshimi, A., Wirk, B., Shaw, B., Freytes, C., LeMaistre, C., Bredeson, C., Dandoy, C., Almaguer, D., ... Saber, W. (2020). Predictors of Loss to Follow-Up Among Pediatric and Adult Hematopoietic Cell Transplantation Survivors: A Report from the Center for International Blood and Marrow Transplant Research. Biology of Blood and Marrow Transplantation, 26(3), 553-561. https://doi.org/10.1016/j.bbmt.2019.11.003