Return to work and work-related disability among AML survivors

Abstract

Acute myeloid leukemia (AML) is an aggressive, acute-onset hematological malignancy. Greater use of intensive chemotherapy (IC), supportive care, and stem cell transplantation have led to an increasing number of long-term survivors. Few studies have examined employment issues among AML survivors and to our knowledge, no study has examined the long-term effects of treatment on return to work. This study is the first to utilize a validated measure of work-related limitation and productivity (WLQ-16) to assess the long-term effects of AML treatment on employment rates, work-related limitations, and overall productivity. We examined RTW issues in 111 adult AML 1-year survivors after conventional IC. We found that, over time, the number of employed survivors increased (to 54% by 36 months) while the number of unemployed, retired, and sick leave patients decreased. Among those employed, the majority were employed full time. Employed individuals reported few work-related limitations and productivity loss scores were low, ranging from 3.47% at 18 months to 2.34% at 36 months. These data suggest that, over time, over half of AML survivors who underwent IC regain social, emotional, cognitive, and physical function sufficient to RTW with few limitations.

Return to Work in Patients with Hematological Cancers 1 Year after Treatment: A Prospective Longitudinal Study

“…This is consistent with results by Bieri and colleagues [10] and with studies on acute myeloid leukemia patients, patients receiving allogenic stem cell transplantation and mixed cancer patients [4,21,22]. A brief review of the literature in the article by Winterling and colleagues [22] shows the heterogeneous study designs of hematological RTW studies, especially regarding follow-up time and the proportion of patients in full-time work before cancer treatment, which makes it difficult to reliably compare results from different studies.…”

Estimating the Productivity Impact of Acute Myeloid Leukemia in Australia Between 2020 and 2029, Using a Novel Work Utility Measure: The Productivity-Adjusted Life Year (PALY)

“…However, the median ages (approximately early 50s) and estimates on return-to-work were relatively similar across two particular studies. 19,22 They estimated that 41% of people were working just after diagnosis and approximately 46% at 12 months after diagnosis. 19 This peaked at 52% at least 10 years after diagnosis.…”

“…19,22 They estimated that 41% of people were working just after diagnosis and approximately 46% at 12 months after diagnosis. 19 This peaked at 52% at least 10 years after diagnosis. 22 We, therefore, assumed a workforce participation of 52%, irrespective of age, sex, or time since diagnosis.…”

“…The literature regarding the impact of AML on productivity was lacking, with no information on absenteeism and presenteeism, and only limited data available regarding labor-force participation. [19][20][21][22][23] The studies we identified varied in sample size, countries or setting, and treatment received. However, the median ages (approximately early 50s) and estimates on return-to-work were relatively similar across two particular studies.…”

Progress and Challenges in Survivorship After Acute Myeloid Leukemia in Adults

“…Along with financial burden, employment can also be distressing for patients. Among 1-year AML survivors, the percentage of full-time employment improves over time with very few limitations in productivity [ 68 •]. Approximately 50% of patients can return to work after allo-HCT [ 69 ].…”