TY - JOUR
T1 - Return to Work Among Young Adult Survivors of Allogeneic Hematopoietic Cell Transplantation in the United States
AU - Bhatt, Neel S.
AU - Brazauskas, Ruta
AU - Salit, Rachel B.
AU - Syrjala, Karen
AU - Bo-Subait, Stephanie
AU - Tecca, Heather
AU - Badawy, Sherif M.
AU - Baker, K. Scott
AU - Beitinjaneh, Amer
AU - Bejanyan, Nelli
AU - Byrne, Michael
AU - Dias, Ajoy
AU - Farhadfar, Nosha
AU - Freytes, César O.
AU - Ganguly, Siddhartha
AU - Hashmi, Shahrukh
AU - Hayashi, Robert J.
AU - Hong, Sanghee
AU - Inamoto, Yoshihiro
AU - Jamani, Kareem
AU - Kasow, Kimberly A.
AU - Khera, Nandita
AU - Krem, Maxwell M.
AU - Lazarus, Hillard M.
AU - Lee, Catherine J.
AU - Lee, Stephanie
AU - Majhail, Navneet S.
AU - Malone, Adriana K.
AU - Marks, David I.
AU - Mau, Lih Wen
AU - Mayo, Samantha J.
AU - Muffly, Lori S.
AU - Nathan, Sunita
AU - Nishihori, Taiga
AU - Page, Kristin M.
AU - Preussler, Jaime
AU - Rangarajan, Hemalatha G.
AU - Rotz, Seth J.
AU - Salooja, Nina
AU - Savani, Bipin N.
AU - Schears, Raquel
AU - Schechter-Finkelstein, Tal
AU - Schiller, Gary
AU - Shah, Ami J.
AU - Sharma, Akshay
AU - Wang, Trent
AU - Wirk, Baldeep
AU - Battiwalla, Minoo
AU - Schoemans, Hélène
AU - Hamilton, Betty
AU - Buchbinder, David
AU - Phelan, Rachel
AU - Shaw, Bronwen
N1 - Funding Information:
Conflict of interest statement: A.S. reports clinical trial salary support from Vertex Pharmaceuticals, CRISPR Therapeutics, and Novartis paid to his institution and personal consultancy fees from Spotlight Therapeutics outside the submitted work. L.S.M. reports grants from Servier, Adaptive, and Astellas and personal fees from Amgen and Pfizer outside the submitted work. Y.I. reports personal fees from Novartis, Janssen, and Meiji Seika Pharma outside the submitted work. S.G. reports personal fees from Seattle Genetics, Kadmon, Kite Pharma, Astellas, Quizartinib, Sanofi, and BMS outside the submitted work. N.B. reports personal fees from Kiadis outside the submitted work.
Funding Information:
Data sharing: The CIBMTR supports the accessibility of research in accordance with the National Institutes of Health (NIH) Data Sharing Policy and the National Cancer Institute (NCI) Cancer Moonshot Public Access and Data Sharing Policy. The CIBMTR releases only deidentified datasets that comply with all relevant global regulations regarding privacy and confidentiality. Financial disclosure: The CIBMTR is supported primarily by Public Health Service U24CA076518 from the National Cancer Institute (NCI), the National Heart, Lung and Blood Institute (NHLBI) and the National Institute of Allergy and Infectious Diseases (NIAID); HHSH250201700006C from the Health Resources and Services Administration (HRSA); and N00014-20-1-2705 and N00014-20-1-2832 from the Office of Naval Research; Support is also provided by Be the Match Foundation, the Medical College of Wisconsin, the National Marrow Donor Program, and from the following commercial entities: Actinium Pharmaceuticals, Inc.; Adienne SA; Allovir, Inc.; Amgen, Inc.; Angiocrine Bioscience; Astellas Pharma US; bluebird bio, Inc.; Bristol Myers Squibb Co.; Celgene Corp.; CSL Behring; CytoSen Therapeutics, Inc.; Daiichi Sankyo Co. Ltd.; ExcellThera; Fate Therapeutics; Gamida-Cell, Ltd.; Genentech Inc; Incyte Corporation; Janssen/Johnson & Johnson; Jazz Pharmaceuticals, Inc.; Kiadis Pharma; Kite, a Gilead Company; Kyowa Kirin; Legend Biotech; Magenta Therapeutics; Merck Sharp & Dohme Corp.; Millennium, the Takeda Oncology Co.; Miltenyi Biotec, Inc.; Novartis Pharmaceuticals Corporation; Omeros Corporation; Oncoimmune, Inc.; Orca Biosystems, Inc.; Pfizer, Inc.; Pharmacyclics, LLC; Sanofi Genzyme; Stemcyte; Takeda Pharma; Vor Biopharma; Xenikos BV. Conflict of interest statement: A.S. reports clinical trial salary support from Vertex Pharmaceuticals, CRISPR Therapeutics, and Novartis paid to his institution and personal consultancy fees from Spotlight Therapeutics outside the submitted work. L.S.M. reports grants from Servier, Adaptive, and Astellas and personal fees from Amgen and Pfizer outside the submitted work. Y.I. reports personal fees from Novartis, Janssen, and Meiji Seika Pharma outside the submitted work. S.G. reports personal fees from Seattle Genetics, Kadmon, Kite Pharma, Astellas, Quizartinib, Sanofi, and BMS outside the submitted work. N.B. reports personal fees from Kiadis outside the submitted work. H.S. reports personal fees and nonfinancial support from Incyte; personal fees from Janssen; grants, personal fees, and nonfinancial support from Novartis; personal fees and nonfinancial support from Jazz Pharmaceuticals; personal fees from Takeda; and nonfinancial support from Celgene, AbbVie, Gilead, and the European Bone Marrow Transplantation Society outside the submitted work. The other authors have no conflicts of interest to report. Financial disclosure: See Acknowledgments on page 679.e7.
Publisher Copyright:
© 2021 The American Society for Transplantation and Cellular Therapy
PY - 2021/8
Y1 - 2021/8
N2 - 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.
AB - 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.
KW - Hematopoietic cell transplantation
KW - Quality of life
KW - Return to work
KW - Young adult
UR - http://www.scopus.com/inward/record.url?scp=85107434203&partnerID=8YFLogxK
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U2 - 10.1016/j.jtct.2021.04.013
DO - 10.1016/j.jtct.2021.04.013
M3 - Article
C2 - 33895402
AN - SCOPUS:85107434203
SN - 2666-6367
VL - 27
SP - 679.e1-679.e8
JO - Transplantation and Cellular Therapy
JF - Transplantation and Cellular Therapy
IS - 8
ER -
