Prevalence of decisional regret among patients who underwent allogeneic hematopoietic stem cell transplantation and associations with quality of life and clinical outcomes
Background Allogeneic hematopoietic stem cell transplantation (alloHCT) is potentially curative but with known negative effects on quality of life. In the current study, the authors investigated whether patients expressed regret after undergoing HCT and the relationships between clinical outcomes an...
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| Veröffentlicht in: | Cancer 2020-06, Vol.126 (11), p.2679-2686 |
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| creator | Cusatis, Rachel N. Tecca, Heather R. D’Souza, Anita Shaw, Bronwen E. Flynn, Kathryn E. |
| description | Background
Allogeneic hematopoietic stem cell transplantation (alloHCT) is potentially curative but with known negative effects on quality of life. In the current study, the authors investigated whether patients expressed regret after undergoing HCT and the relationships between clinical outcomes and quality of life.
Methods
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) before undergoing alloHCT and at day 100 were used. Additional time points were 6 months and 12 months. Regret was measured using a FACT‐BMT item not included in scoring: “I regret having the bone marrow transplant.” The authors evaluated FACT‐BMT scores and regret using Student t‐tests. Covariance pattern models were used to determine predictors of regret over time, including baseline characteristics and post‐alloHCT outcomes (acute or chronic graft‐versus‐host‐disease, disease recurrence).
Results
At 100 days, 6 months, and 12 months, approximately 6% to 8% of patients expressed regret; a total of 15% expressed regret at any time point. Regret was found to be associated with lower FACT‐BMT scores at 6 months and 12 months (P |
| doi_str_mv | 10.1002/cncr.32808 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_webof</sourceid><recordid>TN_cdi_webofscience_primary_000518835300001</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2375860798</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4488-1d774f0ffc89d3ecbfe13d82aba3e29f113b1cf5aa9e1184b9e1d1bf812f7efb3</originalsourceid><addsrcrecordid>eNqNkl2L1DAUhoso7rh64w-QgDeidM1Hu01vBCl-waIiCt6FND2ZyZIms0m6w_wm_6TpdBzUC_Hq5JAnL2_OeYviMcEXBGP6UjkVLhjlmN8pVgS3TYlJRe8WK4wxL-uKfT8rHsR4nduG1ux-ccYoqauWXq6KH58D3EoLTgHyGg2gTDTeSYsCrAMkJEfv1mgrkwGXItptPJrcAGGXWySt9WtwYBTawCiT33oDKXcxwYgUWItSkC5urXQpS3iHpBuQjNErc-izokkbdDNJa9J-tmCNhgOlrHFGZSd-SsqPEB8W97S0ER4d63nx7e2br9378urTuw_d66tSVRXnJRmaptJYa8XbgYHqNRA2cCp7yYC2mhDWE6VrKVsghFd9LgPpNSdUN6B7dl68WnS3Uz_CoPJPg7RiG8wow154acSfN85sxNrfioZSzFmVBZ4dBYK_mSAmMZo4T0M68FMUlDU1v8RNyzP69C_02k8hzz9TFSakJXXDMvV8oVTwMQbQJzMEizkDYs6AOGQgw09-t39Cfy09Ay8WYAe911GZefsnLKekJpyzmuUTJpnm_093Zllz5yeX8lNyfGos7P_hWXQfuy-L-58w5-RB</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2401191573</pqid></control><display><type>article</type><title>Prevalence of decisional regret among patients who underwent allogeneic hematopoietic stem cell transplantation and associations with quality of life and clinical outcomes</title><source>Wiley Online Library - AutoHoldings Journals</source><source>MEDLINE</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Wiley Free Content</source><source>Web of Science - Science Citation Index Expanded - 2020<img src="https://exlibris-pub.s3.amazonaws.com/fromwos-v2.jpg" /></source><source>Alma/SFX Local Collection</source><creator>Cusatis, Rachel N. ; Tecca, Heather R. ; D’Souza, Anita ; Shaw, Bronwen E. ; Flynn, Kathryn E.</creator><creatorcontrib>Cusatis, Rachel N. ; Tecca, Heather R. ; D’Souza, Anita ; Shaw, Bronwen E. ; Flynn, Kathryn E.</creatorcontrib><description>Background
Allogeneic hematopoietic stem cell transplantation (alloHCT) is potentially curative but with known negative effects on quality of life. In the current study, the authors investigated whether patients expressed regret after undergoing HCT and the relationships between clinical outcomes and quality of life.
Methods
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) before undergoing alloHCT and at day 100 were used. Additional time points were 6 months and 12 months. Regret was measured using a FACT‐BMT item not included in scoring: “I regret having the bone marrow transplant.” The authors evaluated FACT‐BMT scores and regret using Student t‐tests. Covariance pattern models were used to determine predictors of regret over time, including baseline characteristics and post‐alloHCT outcomes (acute or chronic graft‐versus‐host‐disease, disease recurrence).
Results
At 100 days, 6 months, and 12 months, approximately 6% to 8% of patients expressed regret; a total of 15% expressed regret at any time point. Regret was found to be associated with lower FACT‐BMT scores at 6 months and 12 months (P < .001). Higher baseline FACT‐BMT and social well‐being scores were associated with a reduced risk of expressing regret. The risk of regretting transplantation was 17.5 percentage points (95% confidence interval, 5.5‐29.7 percentage points) greater in patients who developed disease recurrence after HCT compared with patients who did not.
Conclusions
Among patients who underwent alloHCT and lived to 100 days, the majority did not report regretting their transplantation. Regret was found to be related to disease recurrence. 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.
In the current study, among patients who underwent allogeneic hematopoietic stem cell transplantation and survived to at least 100 days, the majority do not report regretting their transplantation, although approximately 15% do within 1 year. Disease recurrence appears to significantly increase the risk of reporting regret whereas baseline social well‐being significantly decreases the risk of expressing regret.</description><identifier>ISSN: 0008-543X</identifier><identifier>EISSN: 1097-0142</identifier><identifier>DOI: 10.1002/cncr.32808</identifier><identifier>PMID: 32154926</identifier><language>eng</language><publisher>HOBOKEN: Wiley</publisher><subject>Adolescent ; Adult ; Aged ; Aged, 80 and over ; allogeneic hematopoietic stem cell transplantation ; Bone cancer ; Bone marrow ; Bone marrow transplantation ; Clinical outcomes ; Confidence intervals ; Covariance ; Decision Making ; Emotions ; Female ; Functional Assessment of Cancer Therapy–Bone Marrow Transplant (FACT‐BMT) ; Graft vs Host Disease - epidemiology ; Hematopoietic Stem Cell Transplantation - adverse effects ; Hematopoietic Stem Cell Transplantation - psychology ; Hematopoietic stem cells ; Humans ; Life Sciences & Biomedicine ; longitudinal ; Male ; Middle Aged ; Oncology ; Quality of Life ; Recurrence ; regret ; Risk management ; Science & Technology ; Stem cell transplantation ; Stem cells ; Transplantation ; Transplantation, Homologous ; Transplants & implants ; Young Adult</subject><ispartof>Cancer, 2020-06, Vol.126 (11), p.2679-2686</ispartof><rights>2020 American Cancer Society</rights><rights>2020 American Cancer Society.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>true</woscitedreferencessubscribed><woscitedreferencescount>11</woscitedreferencescount><woscitedreferencesoriginalsourcerecordid>wos000518835300001</woscitedreferencesoriginalsourcerecordid><citedby>FETCH-LOGICAL-c4488-1d774f0ffc89d3ecbfe13d82aba3e29f113b1cf5aa9e1184b9e1d1bf812f7efb3</citedby><cites>FETCH-LOGICAL-c4488-1d774f0ffc89d3ecbfe13d82aba3e29f113b1cf5aa9e1184b9e1d1bf812f7efb3</cites><orcidid>0000-0002-1092-5643 ; 0000-0002-4427-3583 ; 0000-0001-6380-1938 ; 0000-0001-6252-6516 ; 0000-0003-3317-1896</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fcncr.32808$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fcncr.32808$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>230,315,782,786,887,1419,1435,27931,27932,28255,45581,45582,46416,46840</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32154926$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Cusatis, Rachel N.</creatorcontrib><creatorcontrib>Tecca, Heather R.</creatorcontrib><creatorcontrib>D’Souza, Anita</creatorcontrib><creatorcontrib>Shaw, Bronwen E.</creatorcontrib><creatorcontrib>Flynn, Kathryn E.</creatorcontrib><title>Prevalence of decisional regret among patients who underwent allogeneic hematopoietic stem cell transplantation and associations with quality of life and clinical outcomes</title><title>Cancer</title><addtitle>CANCER-AM CANCER SOC</addtitle><addtitle>Cancer</addtitle><description>Background
Allogeneic hematopoietic stem cell transplantation (alloHCT) is potentially curative but with known negative effects on quality of life. In the current study, the authors investigated whether patients expressed regret after undergoing HCT and the relationships between clinical outcomes and quality of life.
Methods
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) before undergoing alloHCT and at day 100 were used. Additional time points were 6 months and 12 months. Regret was measured using a FACT‐BMT item not included in scoring: “I regret having the bone marrow transplant.” The authors evaluated FACT‐BMT scores and regret using Student t‐tests. Covariance pattern models were used to determine predictors of regret over time, including baseline characteristics and post‐alloHCT outcomes (acute or chronic graft‐versus‐host‐disease, disease recurrence).
Results
At 100 days, 6 months, and 12 months, approximately 6% to 8% of patients expressed regret; a total of 15% expressed regret at any time point. Regret was found to be associated with lower FACT‐BMT scores at 6 months and 12 months (P < .001). Higher baseline FACT‐BMT and social well‐being scores were associated with a reduced risk of expressing regret. The risk of regretting transplantation was 17.5 percentage points (95% confidence interval, 5.5‐29.7 percentage points) greater in patients who developed disease recurrence after HCT compared with patients who did not.
Conclusions
Among patients who underwent alloHCT and lived to 100 days, the majority did not report regretting their transplantation. Regret was found to be related to disease recurrence. 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.
In the current study, among patients who underwent allogeneic hematopoietic stem cell transplantation and survived to at least 100 days, the majority do not report regretting their transplantation, although approximately 15% do within 1 year. Disease recurrence appears to significantly increase the risk of reporting regret whereas baseline social well‐being significantly decreases the risk of expressing regret.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>allogeneic hematopoietic stem cell transplantation</subject><subject>Bone cancer</subject><subject>Bone marrow</subject><subject>Bone marrow transplantation</subject><subject>Clinical outcomes</subject><subject>Confidence intervals</subject><subject>Covariance</subject><subject>Decision Making</subject><subject>Emotions</subject><subject>Female</subject><subject>Functional Assessment of Cancer Therapy–Bone Marrow Transplant (FACT‐BMT)</subject><subject>Graft vs Host Disease - epidemiology</subject><subject>Hematopoietic Stem Cell Transplantation - adverse effects</subject><subject>Hematopoietic Stem Cell Transplantation - psychology</subject><subject>Hematopoietic stem cells</subject><subject>Humans</subject><subject>Life Sciences & Biomedicine</subject><subject>longitudinal</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Oncology</subject><subject>Quality of Life</subject><subject>Recurrence</subject><subject>regret</subject><subject>Risk management</subject><subject>Science & Technology</subject><subject>Stem cell transplantation</subject><subject>Stem cells</subject><subject>Transplantation</subject><subject>Transplantation, Homologous</subject><subject>Transplants & implants</subject><subject>Young Adult</subject><issn>0008-543X</issn><issn>1097-0142</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>AOWDO</sourceid><sourceid>EIF</sourceid><recordid>eNqNkl2L1DAUhoso7rh64w-QgDeidM1Hu01vBCl-waIiCt6FND2ZyZIms0m6w_wm_6TpdBzUC_Hq5JAnL2_OeYviMcEXBGP6UjkVLhjlmN8pVgS3TYlJRe8WK4wxL-uKfT8rHsR4nduG1ux-ccYoqauWXq6KH58D3EoLTgHyGg2gTDTeSYsCrAMkJEfv1mgrkwGXItptPJrcAGGXWySt9WtwYBTawCiT33oDKXcxwYgUWItSkC5urXQpS3iHpBuQjNErc-izokkbdDNJa9J-tmCNhgOlrHFGZSd-SsqPEB8W97S0ER4d63nx7e2br9378urTuw_d66tSVRXnJRmaptJYa8XbgYHqNRA2cCp7yYC2mhDWE6VrKVsghFd9LgPpNSdUN6B7dl68WnS3Uz_CoPJPg7RiG8wow154acSfN85sxNrfioZSzFmVBZ4dBYK_mSAmMZo4T0M68FMUlDU1v8RNyzP69C_02k8hzz9TFSakJXXDMvV8oVTwMQbQJzMEizkDYs6AOGQgw09-t39Cfy09Ay8WYAe911GZefsnLKekJpyzmuUTJpnm_093Zllz5yeX8lNyfGos7P_hWXQfuy-L-58w5-RB</recordid><startdate>20200601</startdate><enddate>20200601</enddate><creator>Cusatis, Rachel N.</creator><creator>Tecca, Heather R.</creator><creator>D’Souza, Anita</creator><creator>Shaw, Bronwen E.</creator><creator>Flynn, Kathryn E.</creator><general>Wiley</general><general>Wiley Subscription Services, Inc</general><scope>AOWDO</scope><scope>BLEPL</scope><scope>DTL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TO</scope><scope>7U7</scope><scope>C1K</scope><scope>H94</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-1092-5643</orcidid><orcidid>https://orcid.org/0000-0002-4427-3583</orcidid><orcidid>https://orcid.org/0000-0001-6380-1938</orcidid><orcidid>https://orcid.org/0000-0001-6252-6516</orcidid><orcidid>https://orcid.org/0000-0003-3317-1896</orcidid></search><sort><creationdate>20200601</creationdate><title>Prevalence of decisional regret among patients who underwent allogeneic hematopoietic stem cell transplantation and associations with quality of life and clinical outcomes</title><author>Cusatis, Rachel N. ; Tecca, Heather R. ; D’Souza, Anita ; Shaw, Bronwen E. ; Flynn, Kathryn E.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4488-1d774f0ffc89d3ecbfe13d82aba3e29f113b1cf5aa9e1184b9e1d1bf812f7efb3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>allogeneic hematopoietic stem cell transplantation</topic><topic>Bone cancer</topic><topic>Bone marrow</topic><topic>Bone marrow transplantation</topic><topic>Clinical outcomes</topic><topic>Confidence intervals</topic><topic>Covariance</topic><topic>Decision Making</topic><topic>Emotions</topic><topic>Female</topic><topic>Functional Assessment of Cancer Therapy–Bone Marrow Transplant (FACT‐BMT)</topic><topic>Graft vs Host Disease - epidemiology</topic><topic>Hematopoietic Stem Cell Transplantation - adverse effects</topic><topic>Hematopoietic Stem Cell Transplantation - psychology</topic><topic>Hematopoietic stem cells</topic><topic>Humans</topic><topic>Life Sciences & Biomedicine</topic><topic>longitudinal</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Oncology</topic><topic>Quality of Life</topic><topic>Recurrence</topic><topic>regret</topic><topic>Risk management</topic><topic>Science & Technology</topic><topic>Stem cell transplantation</topic><topic>Stem cells</topic><topic>Transplantation</topic><topic>Transplantation, Homologous</topic><topic>Transplants & implants</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Cusatis, Rachel N.</creatorcontrib><creatorcontrib>Tecca, Heather R.</creatorcontrib><creatorcontrib>D’Souza, Anita</creatorcontrib><creatorcontrib>Shaw, Bronwen E.</creatorcontrib><creatorcontrib>Flynn, Kathryn E.</creatorcontrib><collection>Web of Science - Science Citation Index Expanded - 2020</collection><collection>Web of Science Core Collection</collection><collection>Science Citation Index Expanded</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Cancer</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Cusatis, Rachel N.</au><au>Tecca, Heather R.</au><au>D’Souza, Anita</au><au>Shaw, Bronwen E.</au><au>Flynn, Kathryn E.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prevalence of decisional regret among patients who underwent allogeneic hematopoietic stem cell transplantation and associations with quality of life and clinical outcomes</atitle><jtitle>Cancer</jtitle><stitle>CANCER-AM CANCER SOC</stitle><addtitle>Cancer</addtitle><date>2020-06-01</date><risdate>2020</risdate><volume>126</volume><issue>11</issue><spage>2679</spage><epage>2686</epage><pages>2679-2686</pages><issn>0008-543X</issn><eissn>1097-0142</eissn><abstract>Background
Allogeneic hematopoietic stem cell transplantation (alloHCT) is potentially curative but with known negative effects on quality of life. In the current study, the authors investigated whether patients expressed regret after undergoing HCT and the relationships between clinical outcomes and quality of life.
Methods
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) before undergoing alloHCT and at day 100 were used. Additional time points were 6 months and 12 months. Regret was measured using a FACT‐BMT item not included in scoring: “I regret having the bone marrow transplant.” The authors evaluated FACT‐BMT scores and regret using Student t‐tests. Covariance pattern models were used to determine predictors of regret over time, including baseline characteristics and post‐alloHCT outcomes (acute or chronic graft‐versus‐host‐disease, disease recurrence).
Results
At 100 days, 6 months, and 12 months, approximately 6% to 8% of patients expressed regret; a total of 15% expressed regret at any time point. Regret was found to be associated with lower FACT‐BMT scores at 6 months and 12 months (P < .001). Higher baseline FACT‐BMT and social well‐being scores were associated with a reduced risk of expressing regret. The risk of regretting transplantation was 17.5 percentage points (95% confidence interval, 5.5‐29.7 percentage points) greater in patients who developed disease recurrence after HCT compared with patients who did not.
Conclusions
Among patients who underwent alloHCT and lived to 100 days, the majority did not report regretting their transplantation. Regret was found to be related to disease recurrence. 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.
In the current study, among patients who underwent allogeneic hematopoietic stem cell transplantation and survived to at least 100 days, the majority do not report regretting their transplantation, although approximately 15% do within 1 year. Disease recurrence appears to significantly increase the risk of reporting regret whereas baseline social well‐being significantly decreases the risk of expressing regret.</abstract><cop>HOBOKEN</cop><pub>Wiley</pub><pmid>32154926</pmid><doi>10.1002/cncr.32808</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-1092-5643</orcidid><orcidid>https://orcid.org/0000-0002-4427-3583</orcidid><orcidid>https://orcid.org/0000-0001-6380-1938</orcidid><orcidid>https://orcid.org/0000-0001-6252-6516</orcidid><orcidid>https://orcid.org/0000-0003-3317-1896</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Adolescent Adult Aged Aged, 80 and over allogeneic hematopoietic stem cell transplantation Bone cancer Bone marrow Bone marrow transplantation Clinical outcomes Confidence intervals Covariance Decision Making Emotions Female Functional Assessment of Cancer Therapy–Bone Marrow Transplant (FACT‐BMT) Graft vs Host Disease - epidemiology Hematopoietic Stem Cell Transplantation - adverse effects Hematopoietic Stem Cell Transplantation - psychology Hematopoietic stem cells Humans Life Sciences & Biomedicine longitudinal Male Middle Aged Oncology Quality of Life Recurrence regret Risk management Science & Technology Stem cell transplantation Stem cells Transplantation Transplantation, Homologous Transplants & implants Young Adult |
| title | Prevalence of decisional regret among patients who underwent allogeneic hematopoietic stem cell transplantation and associations with quality of life and clinical outcomes |
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