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Hematopoietic cell donor type may not impact quality of life post-transplant
Research presented at the 64th American Society of Hematology (ASH) Annual Meeting and Exposition reviewed patient-reported quality of life (QoL) outcomes as an extension of a Blood and Marrow Transplant Clinical Trials Network (BMT CTN) study (BMT CTN 1101). The data showed no significant differences in post-transplant QoL between patients receiving haploidentical (haplo) or double umbilical cord blood (UCB) hematopoietic cell transplant (HCT) at any time point, as well as no significant association between pre-transplant QoL and overall survival or progression-free survival.
This study further corroborates results from BMT CTN 1102, finding pre-transplant QoL remains a significant predictor of post-transplant QoL.
BMT CTN 1101 was a clinical trial that compared outcomes of double UCB and haplo transplant recipients who received reduced intensity conditioning. Patient-reported outcomes are an important way to include the patient’s perspective in research studies as opposed to the inclusion of only clinical and biological outcomes.
By further examining patient-reported QoL data from BMT CTN 1101, this study provides insight into whether donor source impacts patient QoL post-transplant and if there is an association between QoL and clinical outcomes.
Enrollment of the initial trial from June 2012–June 2018 included 368 patients with blood cancer (leukemia or lymphoma) ages 18-70, and at least 2 years of follow-up post-transplant. This study focused on patient-reported QoL outcomes gathered from patients who were randomly assigned to either haplo or double UCB HCT with reduced-intensity conditioning for BMT CTN 1101.
QoL assessments were completed pre-transplant, 1-year post-transplant, and 2-years post-transplant. Assessments included survey-based questionnaires focused on physical, mental, and overall health reported by patients at specified time intervals.
There were no significant differences in QoL between the two groups at any time point, as shown in Figure 1 below. In addition, there were no significant associations between pre-transplant QoL and overall survival or progression-free survival. There was also no significant association between the patient's group or their baseline clinical variables with scores post-transplant.
Lower post-transplant QoL scores were associated with disease relapse, high-grade acute graft-versus-host disease (GVHD), and chronic GVHD.
As seen in previous studies, pre-transplant QoL scores were a significant predictor of post-transplant QoL scores.
Patient reported outcomes provide valuable insights into treatment decisions. In this case, the choice of donor type—double UCB or haplo related donor—did not impact patient-reported QoL suggesting either may be a suitable option.
Pre-transplant QoL continues to be a significant indicator of post-transplant QoL, confirming the importance of QoL as part of pre-transplant performance assessments. The National Marrow Donor Program®/Be The Match® is committed to further studying the critically important metric of patient QoL.
Najla El J, et al., ASH oral presentation abstract