Pre-Transplant Marital Status and Hematopoietic Cell Transplantation Outcomes
by
J. Tay
1,*, 
S. Beattie
1,
C. Bredeson
2,
R. Brazauskas
3,
N. He
3,
I. A. Ahmed
3,
M. Aljurf
4,
M. Askar
3,
Y. Atsuta
5,
S. Badawy
3,
A. Barata
6,
A. M. Beitinjaneh
3,
N. S. Bhatt
3,
D. Buchbinder
3,
J. Cerny
3,
S. Ciurea
3,
A. D’Souza
3,
J. Dalal
3,
N. Farhadfar
3,
C. O. Freytes
3, add
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1
Tom Baker Cancer Centre, University of Calgary, Calgary, AB, Canada
2
The Ottawa Hospital Blood and Marrow Transplant Program and The Ottawa Hospital Research Institute, Ottawa, ON, Canada
3
Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D’Souza, Chhabra, Saber);Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children’s Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children’s Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children’s Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children’s Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children’s Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/ Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD, USA
4
Department of Oncology, King Faisal Specialist Hospital Center and Research, Riyadh, Saudi Arabia
5
Japanese Data Center for Hematopoietic Cell Transplantation, Nagoya (Atsuta); Nagoya University Graduate School of Medicine, Nagoya (Atsuta); Division of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo (Inamoto); Department of Hematology and Oncology, Dokkyo Medical University, Tochigi, Japan;
6
Hospital de la Santa Creu i Sant Pau, Barcelona (Barata); Department of Hematology/Oncology, Hospital Infantil Universitario Nino Jesus, Madrid, Spain
7
Department of Hematology, University Hospital, Basel, Switzerland
8
Division of Transplantation and Immunogenetics, Department of Pathology, Queen Mary Hospital, Hong Kong, China
9
Department of Laboratory Medicine, Karolinska Institutet, Stockholm (Olsson); Centre for Clinical Research Sormland, Uppsala University, Uppsala, Sweden
10
University Hospital Leuven and KU Leuven, Leuven, Belgium
11
Department of Hematology, Acadeische Ziekenhuis, Maastrict (Schouten); Department of Hematology/Oncology, Isala Clinic, Zwolle, The Netherlands
12
Clinical Haematology, Peter MacCallum Cancer Centre and The Royal Melbourne Hospital, Melbourne, VIC, Australia
13
CancerCare Manitoba, Winnipeg, MB, Canada
*
Author to whom correspondence should be addressed.
Curr. Oncol. 2020, 27(6), 596-606; https://doi.org/10.3747/co.27.6327
Submission received: 11 September 2020
/
Revised: 8 October 2020
/
Accepted: 9 November 2020
/
Published: 1 December 2020
Abstract
Background: Evidence about the impact of marital status before hematopoietic cell transplantation (hct) on outcomes after hct is conflicting. Methods: We identified patients 40 years of age and older within the Center for International Blood and Marrow Transplant Research registry who underwent hct between January 2008 and December 2015. Marital status before hct was declared as one of: married or living with a partner, single (never married), separated or divorced, and widowed. We performed a multivariable analysis to determine the association of marital status with outcomes after hct. Results: We identified 10,226 allogeneic and 5714 autologous hct cases with, respectively, a median follow-up of 37 months (range: 1–102 months) and 40 months (range: 1–106 months). No association between marital status and overall survival was observed in either the allogeneic (p = 0.58) or autologous (p = 0.17) setting. However, marital status was associated with grades 2–4 acute graft-versus-host disease (gvhd), p < 0.001, and chronic gvhd, p = 0.04. The risk of grades 2–4 acute gvhd was increased in separated compared with married patients [hazard ratio (hr): 1.13; 95% confidence interval (ci): 1.03 to 1.24], and single patients had a reduced risk of grades 2–4 acute gvhd (hr: 0.87; 95% ci: 0.77 to 0.98). The risk of chronic gvhd was lower in widowed compared with married patients (hr: 0.82; 95% ci: 0.67 to 0.99). Conclusions: Overall survival after hct is not influenced by marital status, but associations were evident between marital status and grades 2–4 acute and chronic gvhd. To better appreciate the effects of marital status and social support, future research should consider using validated scales to measure social support and patient and caregiver reports of caregiver commitment, and to assess health-related quality of life together with health care utilization.
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MDPI and ACS Style
Tay, J.; Beattie, S.; Bredeson, C.; Brazauskas, R.; He, N.; Ahmed, I.A.; Aljurf, M.; Askar, M.; Atsuta, Y.; Badawy, S.; et al. Pre-Transplant Marital Status and Hematopoietic Cell Transplantation Outcomes. Curr. Oncol. 2020, 27, 596-606. https://doi.org/10.3747/co.27.6327
AMA Style
Tay J, Beattie S, Bredeson C, Brazauskas R, He N, Ahmed IA, Aljurf M, Askar M, Atsuta Y, Badawy S, et al. Pre-Transplant Marital Status and Hematopoietic Cell Transplantation Outcomes. Current Oncology. 2020; 27(6):596-606. https://doi.org/10.3747/co.27.6327
Chicago/Turabian StyleTay, J., S. Beattie, C. Bredeson, R. Brazauskas, N. He, I. A. Ahmed, M. Aljurf, M. Askar, Y. Atsuta, S. Badawy, and et al. 2020. "Pre-Transplant Marital Status and Hematopoietic Cell Transplantation Outcomes" Current Oncology 27, no. 6: 596-606. https://doi.org/10.3747/co.27.6327
