Lack of association between relationship status and clinical outcome in allogeneic stem cell transplantation—the Swiss Transplant Cohort Study

Gerull, Sabine; Denhaerynck, Kris; Chalandon, Yves; Kirsch, Monika; Kiss, Alexander; Schanz, Urs; Vu, Diem‐Lan; Geest, Sabina De; Passweg, Jakob

doi:10.1038/bmt.2017.204

Cited by 5 publications

(6 citation statements)

References 16 publications

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“…Over the last half-century, numerous studies from different disciplines have investigated relations between marital status and various aspects of health, including cardiovascular, immune, psychiatric and behavioral-related indices [2]. However, findings on the relationship between marital status and health or mortality have been inconsistent [3]. A number of studies conducted on samples from various ethnic groups have reported that rate of all-cause and cause-specific mortality are higher among those who are unmarried, relative to their married counterparts, a relationship which is independent of various sociodemographic characteristics [4, 5].…”

Section: Introductionmentioning

confidence: 99%

Associations of marital status with diabetes, hypertension, cardiovascular disease and all-cause mortality: A long term follow-up study

2019

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Background To investigate the associations of marital status with major clinical outcomes including type 2 diabetes (T2D), hypertension, cardiovascular disease (CVD) and all-cause mortality. Methods The study cohort (1999–2014) included 9,737 (45% male) Iranian adults with a mean age of 47.6 years. Marital status was defined as married versus never married, divorced and widowed. The relationship between marital status and the four above mentioned outcomes were investigated using Cox regression models adjusted for the main confounders, specific to each outcome. Results After more than 12 years of follow-up, 1,889 (883 men) individuals developed hypertension, 1,038 (468 men) T2D, 1015 (597 men) CVD and 668 (409 men) all-cause mortality. Compared with married, being never married in men was associated with higher risk of hypertension [hazard ratio (HR): 1.55; 95% confidence interval (CI), 1.11–2.16] and all-cause mortality (2.17; 0.95–5.00; p-value = 0.066) after adjusting for confounders. Among women, compared with married status, widowed status was associated with a lower risk of T2D (0.74; 0.56–0.97) in the confounders adjusted model. Moreover, never married women had a lower risk of hypertension (0.58; 0.37–0.90) compared to married ones in the age adjusted model, a finding that did not achieve significance, after further adjustment for confounders. Conclusion We found that the relationship between marital status and health outcomes varied by gender. Being never married was an important risk factor for hypertension and tended to be a significant risk factor for mortality in men. However, among women, being widowed was associated with a lower risk of T2D.

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Section: Introductionmentioning

confidence: 99%

Associations of marital status with diabetes, hypertension, cardiovascular disease and all-cause mortality: A long term follow-up study

2019

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“…Our findings suggest that lay caregivers and healthcare providers each serve the patients in different ways. Moreover, the different sources and networks of social support in Study 2 (see Figure 1) suggest that information on marital status misses the contribution of other lay caregivers, which may explain why these studies found no link between marital status and survival (Gerull et al, 2017;Sato et al, 2018;Tay et al, 2020). More nuanced measures of support than marital status should be considered for future research.…”

Section: Discussionmentioning

confidence: 97%

“…Three additional studies that used marital status as a support indicator failed to find a link with survival in large samples of patients after alloHCT (N = 10,226, Tay et al, 2020;N = 715, Gerull et al, 2017;N = 309;Sato et al, 2018). However, two of these studies still found some evidence that social support could matter for survival: Tay et al (2020) found an association for graft-versus-host disease (GvHD), while Gerull et al (2017) found that patients with missing information on marital status had worse survival than those with available information.…”

Section: Introductionmentioning

confidence: 99%

It Takes a Team to Make It Through: The Role of Social Support for Survival and Self-Care After Allogeneic Hematopoietic Stem Cell Transplant

et al. 2021

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BackgroundSocial support plays an important role for health outcomes. Support for those living with chronic conditions may be particularly important for their health, and even for their survival. The role of support for the survival of cancer patients after receiving an allogeneic hematopoietic cell transplant (alloHCT) is understudied. To better understand the link between survival and support, as well as different sources and functions of support, we conducted two studies in alloHCT patients. First, we examined whether social support is related to survival (Study 1). Second, we examined who provides which support and which specific support-related functions and tasks are fulfilled by lay caregivers and healthcare professionals (Study 2).MethodsIn Study 1, we conducted a retrospective chart review of alloHCT patients (N = 173, 42.8% female, age: M = 49.88) and registered availability of a dedicated lay caregiver and survival. In Study 2, we prospectively followed patients after alloHCT (N = 28, 46.4% female, age: M = 53.97, 46.4% ethnic minority) from the same hospital, partly overlapping from Study 1, who shared their experiences of support from lay caregivers and healthcare providers in semi-structured in-depth interviews 3 to 6 months after their first hospital discharge.ResultsPatients with a dedicated caregiver had a higher probability of surviving to 100 days (86.7%) than patients without a caregiver (69.6%), OR = 2.84, p = 0.042. Study 2 demonstrated the importance of post-transplant support due to patients’ emotional needs and complex self-care regimen. The role of lay caregivers extended to many areas of patients’ daily lives, including support for attending doctor’s appointments, managing medications and financial tasks, physical distancing, and maintaining strict dietary requirements. Healthcare providers mainly fulfilled medical needs and provided informational support, while lay caregivers were the main source of emotional and practical support.ConclusionThe findings highlight the importance of studying support from lay caregivers as well as healthcare providers, to better understand how they work together to support patients’ adherence to recommended self-care and survival.

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“…In contrast to studies in general oncology and specific malignancies, two published studies have assessed marital status with respect to hct outcomes, and both demonstrated the lack of an association. Gerull et al 5 examined 715 patients who received allogeneic hct between 2009 and February 2015 in the Swiss Transplant Cohort Study. The authors classified marital status as either single (encompassing single, divorced or separated, and widowed) or in a stable partnership.…”

Section: Discussionmentioning

confidence: 99%

“…Interest has been increasing in evaluating the potential impact of psychosocial variables-for example, marital status-on hct outcomes. The results of observational single-centre and registry studies evaluating the association between marital status and outcomes of hematologic malignancies, including hct outcomes, have been inconsistent [3][4][5][6][7][8][9][10] .…”

Section: Introductionmentioning

confidence: 99%

Pre-Transplant Marital Status and Hematopoietic Cell Transplantation Outcomes

et al. 2020

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Background Evidence regarding the impact of pre-hematopoietic cell transplantation (HCT) marital status on post-HCT outcomes is conflicting. Methods We identified patients, ≥40-years within the Center for International Blood and Marrow Transplant Research registry who received a HCT between January 2008 and December 2015. Pre-HCT marital status was declared as either 1) Married/living with a partner, 2) Single/never married, 3) Separated/divorced, and 4) Widowed. We performed multivariable analysis to determine the association of marital stsatus with post-HCT outcomes. Results We identified 10,226 allogeneic and 5,714 autologous HCT patients with a median follow-up of 37 months (range 1-102) and 40 months (range 1-106) respectively. There was no association between marital status and OS in both allogeneic (p=0.58) and autologous (p=0.17) settings. However, marital status was associated with grade 2-4 acute GVHD (p<0.001) and chronic GVHD (p=0.04). There was an increased risk of grade 2-4 acute GVHD in separated patients compared with married patients [HR 1.13, 95%CI (1.03-1.24)], while single patients had a reduced risk of grade 2-4 acute GVHD [HR 0.87, 95%CI (0.77-0.98)]. The risk of chronic GVHD was lower in widowed patients [HR 0.82, 95%CI (0.67-0.99)] compared with married patients. Conclusions OS post-HCT is not influenced by marital status, but there are associations between marital status and grade 2-4 acute and chronic GVHD. Future research should consider measuring social support using validated scales, patient and caregiver reports of caregiver commitment, and assess health-related quality of life together with health-care utilization to better appreciate the impact of marital status and social support.

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Lack of association between relationship status and clinical outcome in allogeneic stem cell transplantation—the Swiss Transplant Cohort Study

Cited by 5 publications

References 16 publications

Associations of marital status with diabetes, hypertension, cardiovascular disease and all-cause mortality: A long term follow-up study

Associations of marital status with diabetes, hypertension, cardiovascular disease and all-cause mortality: A long term follow-up study

It Takes a Team to Make It Through: The Role of Social Support for Survival and Self-Care After Allogeneic Hematopoietic Stem Cell Transplant

Pre-Transplant Marital Status and Hematopoietic Cell Transplantation Outcomes

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