Pattern of employment and associated factors in long-term lymphoma survivors 10 years after high-dose chemotherapy with autologous stem cell transplantation

Ce, Kiserud; Um, Fagerli; Kb, Smeland; Fluge, Øystein; Bersvendsen, Hanne Skjerven; Kvaløy, Stein; Holte, Harald; Dahl, Arve

doi:10.3109/0284186x.2015.1125015

Cited by 27 publications

(37 citation statements)

References 18 publications

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“…Cost analysis was also in favor of peripheral blood stem cell grafts. Other pretransplantation characteristics, such as socioeconomic status, income, marital status, and psychological distress, are known to impact QoL after AHSCT [25][26][27].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the Impact of Autologous Hematopoietic Stem Cell Transplantation on the Quality of Life of Older Patients with Lymphoma

Lemieux

Ahmad

Bambace

et al. 2020

Biology of Blood and Marrow Transplantation

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A B S T R A C T High-dose chemotherapy (HDT) followed by autologous hematopoietic stem cell transplantation (AHSCT) improves survival in patients with chemosensitive non-Hodgkin lymphoma (NHL). Determination of the Hematopoietic Cell Transplantation Comorbidity Index (HCT-CI) has contributed to improve patient selection while allowing for prediction of nonrelapse mortality. We previously demonstrated the efficacy and safety of AHSCT in a cohort of older patients with chemosensitive NHL. Quality of life following AHSCT still has not been widely evaluated. The goal of this study was to assess the long-term quality of life of elderly patients surviving AHSCT. This single-center, Research and Ethics Committee-approved study investigated QoL in survivors of AHSCT for the treatment of NHL in a cohort of older patients. Inclusion criteria were defined as patients age 60 years who underwent AHSCT for NHL between January 1, 2008, and January 1, 2015, at our center. Fifty-nine patients from the original cohort of 90 survived at a median of 50 months post-AHSCT. Forty-seven (79.7%) of those patients agreed to complete the QoL assessment questionnaires after the transplantation and are included in this report. All patients provided signed informed consent. We used the EQ-5D instrument to assess mobility, self-care, usual activities, pain/discomfort, and anxiety/depression and the Functional Assessment of Cancer Therapy-Bone Marrow Transplant (FACT-BMT) questionnaire to assess physical, social/family, emotional, and functional well-being and BMT-specific concerns. With both tools, a higher score indicates better QoL. Fifteen percent of patients were in relapse at the time of the QoL assessment. In the EQ-5D, few patients (9%) reported severe impairment, which requires significant negative effects in 4 or 5 domains. Lower Karnofsky Performance Status (KPS) score at the time of transplantation was negatively correlated with mobility (P= .001), self-care (P= .001), and usual activities (P= .007) dysfunction. Anxiety was significant for patients in relapsed after transplantation (P= .002). FACT-BMT questionnaire results demonstrated that physical, social, and emotional well-being were all well preserved after the transplantation, whereas functional well-being was more variable among patients. Relapse was associated with impaired functional well-being (P= .007) and lower total FACT-BMT score (P= .014). Other comparators, including the conditioning regimen, sex, age subgroups (<65 or 65 years), HCT-CI score, and disease status at transplantation, did not impact any of these outcomes. This study demonstrates that physical, social, and functional well-being are preserved in older patients following AHSCT. Low KPS score before AHSCT is a predictor of disability at distance from AHSCT. Relapse following AHSCT remains the most significant impediment to maintaining a good QoL. Innovative interventions to improve performance status before transplantation and measures to prevent relapse thereafter should be investigated to improve survival...

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Section: Discussionmentioning

confidence: 99%

Evaluation of the Impact of Autologous Hematopoietic Stem Cell Transplantation on the Quality of Life of Older Patients with Lymphoma

Lemieux

Ahmad

Bambace

et al. 2020

Biology of Blood and Marrow Transplantation

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“…They found younger age to be associated with an improved RTW rate 28. A recent Norwegian cross-sectional study on 312 long-term lymphoma survivors treated with ASCT between 1987 and 2008 showed that older age was associated with a higher risk of having a not-employed status (odds ratio 1.04 [1.0;1.1]) 18. In the Norwegian study, the not-employed status covered sick leave, disability pension, and old-age pension.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, the registries used are designed for administrative purposes, which limited the possibility for us to obtain more detailed information. There is no information on self-reported symptoms like quality of life or physical impairments, which have been shown to be associated with work market affiliation after ASCT 16,18. Future studies might combine register data with questionnaires in order to explore the association between these factors.…”

Section: Discussionmentioning

confidence: 99%

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Return to work for patients with diffuse large B-cell lymphoma and transformed indolent lymphoma undergoing autologous stem cell transplantation

Arboe¹,

Olsen²,

Goerloev³

et al. 2017

CLEP

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BackgroundAutologous stem cell transplantation (ASCT) is the standard treatment for patients with relapsed diffuse large B-cell lymphoma (DLBCL) or transformed indolent lymphoma (TIL). The treatment is mainly considered for younger patients still available for the work market. In this study, social outcomes after ASCT in terms of return to work (RTW) are described.Patients and methodsInformation from national administrative registers was combined with clinical information on patients, who received ASCT for relapse of DLBCL or TIL between 2000 and 2012. A total of 164 patients were followed until RTW, disability or old-age pension, death, or December 31, 2015, whichever came first. A total of 205 patients were followed with disability pension as the event of interest. Cox models were used to determine cause-specific hazards.ResultsDuring follow-up, 82 (50%) patients returned to work. The rate of returning to work in the first year following ASCT was decreased for patients being on sick leave at the time of relapse (hazard ratio [HR] 0.3 [0.2;0.5]) and increased for patients aged ≥55 years (HR 1.9 [1.1;3.3]). In all, 56 (27%) patients were granted disability pension. Being on sick leave at the time of relapse was positively associated with receiving a disability pension in the first 2 years after ASCT (HR 3.7 [1.8;7.7]).ConclusionPatients on sick leave at the time of relapse have a poorer prognosis regarding RTW and have a higher rate of disability pension. Furthermore, patients >55 are more likely to RTW compared to younger patients. These results indicate an unmet need for focused social rehabilitation.

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“…The data source is a national multicentre cross-sectional follow-up study performed in 2012-2013 consisting of a detailed self-reported questionnaire [2,5], results from a clinical examination [6], as well as data retrieved from patients' charts and the clinical quality register for lymphoma at Oslo University Hospital (OUH). Survivors of HDT-ASCT, treated with BEAM (carmustine, etoposide, cytarabine and melphalan) as high-dose regimen for lymphoma in Norway between 1995 and 2008, aged >= 18 years at HDT-ASCT, alive at survey, residing in Norway and currently not undergoing systemic therapy for active malignancy were eligible (n=355, figure 1).…”

Section: Patientsmentioning

confidence: 99%

Post-treatment work patterns amongst survivors of lymphoma treated with high-dose chemotherapy with autologous stem-cell transplantation

Hernæs

Smeland²,

Fagerli

et al. 2020

Preprint

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BackgroundThis study describes post-treatment work patterns in lymphoma survivors treated with high-dose chemotherapy with autologous stem-cell transplantation (HDT-ASCT). It aims to identify determinants for labour force participation and exclusion after HDT-ASCT.MethodsEligible patients were survivors of HDT-ASCT for lymphoma in Norway between 1995 and 2008, aged >= 18 years at HDT-ASCT. We divide survivors by current employment status (working (full vs. part-time) and unemployed). Main outcomes are current employment status, work hours and work ability. Withdrawals are patients who were employed when diagnosed but not before HDT-ASCT.ResultsOf the 274 who completed the survey, 82% (N=225) were included in the final analyses. Mean age at survey was 52 years, 39% were female, 85% were employed when diagnosed, 77% before HDT-ASCT and 69% at survey. Employment before HDT-ASCT corresponds with a higher probability of employment at survey for a given symptom burden. In the most extensive statistical model, it increases with 37.3 percentage points. Work hours amongst withdrawals plummet after HDT-ASCT while work ability shows a rebound effect. The potential economic gain from their re-enter into the work force equals 2/3 of the average annual wage in Norway in 2012.ConclusionsFor a given symptom burden, staying employed throughout diagnosis and treatment is associated with a higher probability of future employment. These results favour policies for labour force inclusion past diagnosis and treatment increasing cancer survivors’ probability of future employment. However, we need more research on withdrawal mechanisms, and on policy measures that promote inclusion.

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Pattern of employment and associated factors in long-term lymphoma survivors 10 years after high-dose chemotherapy with autologous stem cell transplantation

Cited by 27 publications

References 18 publications

Evaluation of the Impact of Autologous Hematopoietic Stem Cell Transplantation on the Quality of Life of Older Patients with Lymphoma

Evaluation of the Impact of Autologous Hematopoietic Stem Cell Transplantation on the Quality of Life of Older Patients with Lymphoma

Return to work for patients with diffuse large B-cell lymphoma and transformed indolent lymphoma undergoing autologous stem cell transplantation

Post-treatment work patterns amongst survivors of lymphoma treated with high-dose chemotherapy with autologous stem-cell transplantation

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