Prevalence of decisional regret among patients who underwent allogeneic hematopoietic stem cell transplantation and associations with quality of life and clinical outcomes

Details

• Alternative Title:
  Cancer
• Personal Author:
  Cusatis, Rachel ; Tecca, Heather R ; D’Souza, Anita ; Shaw, Bronwen E ; Flynn, Kathryn E.
• Description:
  Background
  
  Allogeneic hematopoietic cell transplantation (alloHCT) is a potentially curative but with known negative effects on quality of life. We investigated whether patients expressed regret after HCT and the relationships between clinical outcomes, and quality of life.
  
  Methods
  
  We used Center for International Blood and Marrow Transplant Research data from 184 adults who completed the Functional Assessment of Cancer Therapy-Bone Marrow Transplant (FACT-BMT) pre-alloHCT and at day 100. Additional timepoints were 6 and 12 months. Regret was measured with a FACT-BMT item not included in scoring, “I regret having the bone marrow transplant.” We evaluated FACT-BMT scores and regret using t-tests. We used covariance pattern models to determine predictors of regret over time, including baseline characteristics and post-alloHCT outcomes (acute or chronic graft-versus-host-disease; disease relapse).
  
  Results
  
  At 100 days, 6 and 12 months, 6–8% of patients expressed regret; a total of 15% expressed regret at any timepoint. Regret was associated with lower FACT-BMT at 6 and 12 months (p<0.001). Higher baseline FACT-BMT and social well-being were associated with a reduced risk of expressing regret. The risk of regretting transplantation was 17.5 percentage points (CI 5.5–29.7) greater in patients that relapsed post-HCT, compared to patients who did not.
  
  Conclusions
  
  Among alloHCT patients who lived to 100 days, most did not report regretting their transplant. Regret was related to disease relapse. Social connectedness may serve as a protective factor against later regret. Future work should explore regret in other patient groups and use qualitative methods to inform best practices for reducing regret.
  
  
• Subjects:
  Adolescent Adult Aged Aged, 80 And Over Decision Making Emotions Female Graft Vs Host Disease Hematopoietic Stem Cell Transplantation Humans Male Middle Aged Quality Of Life Recurrence Transplantation, Homologous Young Adult

  More +
• Keywords:
  Allogeneic Hematopoietic Stem Cell Transplantation FACT-BMT Longitudinal Regret
• Source:
  Cancer. 126(11):2679-2686
• Pubmed ID:
  32154926
• Pubmed Central ID:
  PMC7220834
• Document Type:
  Journal Article
• Funding:
  U10 HL069294/HL/NHLBI NIH HHSUnited States/ ; R01 CA152108/CA/NCI NIH HHSUnited States/ ; U01 HL128568/HL/NHLBI NIH HHSUnited States/ ; U24 HL138660/HL/NHLBI NIH HHSUnited States/ ; R01 HL131731/HL/NHLBI NIH HHSUnited States/ ; HHSH250201700006C/HRSA/HRSA HHSUnited States/ ; U01 HL069294/HL/NHLBI NIH HHSUnited States/ ; U01 AI126612/AI/NIAID NIH HHSUnited States/ ; R01 HL126589/HL/NHLBI NIH HHSUnited States/ ; R21 HL140314/HL/NHLBI NIH HHSUnited States/ ; T42 OH008434/OH/NIOSH CDC HHSUnited States/ ; U24 CA076518/CA/NCI NIH HHSUnited States/ ; R01 CA231141/CA/NCI NIH HHSUnited States/ ; R01 HL129472/HL/NHLBI NIH HHSUnited States/ ; P01 CA111412/CA/NCI NIH HHSUnited States/
• Volume:
  126
• Issue:
  11
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:688f2592981741fc7fd8676fbd7ad7b05e0a53ad28ffb5e794342b61c7fd7a8b
• Download URL:
  https://stacks.cdc.gov/view/cdc/88015/cdc_88015_DS1.pdf
• File Type:
  [PDF - 512.54 KB ]