Abstract # 1729 Psychosocial and socioeconomic status as predictors of outcomes following hematopoietic stem cell transplantation: An ancillary study from the BMT CTN 0902 randomized controlled trial (RCT)

Psychosocial and socioeconomic factors have predicted morbidity and mortality following hematopoietic cell transplantation (HCT). However, previous studies suffer from methodological limitations, and few investigate biobehavioral pathways. This multi-center study assessed whether pre-HCT psychosocial and socioeconomic measures are associated with each other and predictive of clinical outcomes including hematopoietic recovery, acute graft versus host disease, hospitalization days, and overall survival (OS) in the 711 participants in the BMT CTN 0902, an RCT of pre-transplant exercise and stress management for autologous and allogeneic HCT recipients. Pre-transplant Cancer and Treatment Distress (CTXD), Pittsburgh Sleep Quality Index (PSQI), and mental and physical component scores (MCS and PCS) of the SF-36 were tested in baseline correlations with socioeconomic assessments; all were evaluated as predictors of clinical outcomes, with the PSQI and CTXD evaluated as OS predictors ( p < .01 considered significant; adjusted for multiple testing). Lower education was associated with increased distress ( p = .002); lower pre-transplant income was related to worse physical functioning ( p = .005) and increased distress ( p = .008); lack of employment at the time of transplant was associated with worse physical functioning ( p < .01); not being married was associated with worse sleep ( p = .003). In this large heterogeneous cohort of HCT recipients, while socioeconomic and psychosocial factors were correlated at baseline, they were not associated with any clinical outcomes as has been previously reported, highlighting the complexity of biobehavioral relationships in HCT.