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
  More +
• Keywords:
  • allogeneic hematopoietic stem cell transplantation
  • regret
  • FACT-BMT
  • longitudinal
• 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/
  More +
• Volume:
  126
• Issue:
  11
• Download URL:
  https://stacks.cdc.gov/view/cdc/88015/cdc_88015_DS1.pdf
• File Type:
  [PDF - 512.54 KB]
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:688f2592981741fc7fd8676fbd7ad7b05e0a53ad28ffb5e794342b61c7fd7a8b