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 - 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
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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 -