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Quality of Life Research
Published in: Quality of Life Research 12/2021

01-12-2021 | Stem Cell Transplantion

Health-related quality of life predicts length of hospital stay and survival rates for pediatric patients receiving allogeneic hematopoietic cell transplantation

Authors: Ying-Mei Liu, Tang-Her Jaing, Yu-Chuan Wen, Shih-Hsiang Chen, Pei-Yin Weng, Lin Lin, Chia-Ling Wu

Published in: Quality of Life Research | Issue 12/2021

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Abstract

Purpose

We examined the association between health-related quality of life (HRQoL) of pediatric patients during hospitalization for allogeneic hematopoietic cell transplantation (HCT) and length of hospital stay, and 1-year survival.

Methods

Primary family caregivers were proxy-assessors for the Pediatric Quality of Life (PedsQL) Stem Cell Transplant Module at three time points: 5-days pre-HCT (T0); 14-days post-HCT (engraftment, T1); and 1-week before hospital discharge (T2). Cox regression analyses determined predictors of the overall 1-year survival after allogeneic HCT.

Results

Thirty-nine eligible caregivers completed all assessments. The mean age of the pediatric patients was 9.07 years (SD = 5.2). PedsQL Stem Cell Transplant Module scores decreased from 71.33 (SD = 13.26) at T0 to 55.41(SD = 13.05) at T1 (p < 0.001) and increased to 68.46 (SD = 13.97) at T2 (p < 0.001). There was no significant difference between scores at T0 and T2. Longer length of hospital stay was associated with children who were younger and had greater relative changes in scores on the caregiver-proxy PedsQL Stem Cell Transplant Module from T0 to T1. PedsQL Stem Cell Transplant Module scores ≥ 58.07 at T2 were associated with higher 1-year survival rates (Hazard Ratio = 0.12, 95% Confidence Interval = 0.02–0.78; p = 0.03).

Conclusion

Our findings suggest that assessment of HRQoL during early HCT can add prognostic value beyond demographic and HCT factors. Understanding the HRQoL status during hospitalization for HCT could help identify pediatric patients with low prospects of 1-year survival in order to provide support interventions to improve HRQoL and survival rates.
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Literature
1.
Nava, T., Ansari, M., Dalle, J. H., de Heredia, C. D., Güngör, T., Trigoso, E., Falkenberg, U., Bertaina, A., Gibson, B., Jarisch, A., & Balduzzi, A. (2020). Supportive care during pediatric hematopoietic stem cell transplantation: Beyond infectious diseases. A report from workshops on supportive care of the pediatric diseases working party (PDWP) of the European Society for Blood and Marrow Transplantation (EBMT). Bone Marrow Transplantation, 55, 1126–1136.CrossRef
2.
Rangarajan, H. G., Smith, L. C., Stanek, J. R., Hall, M., Abu-Arja, R., Auletta, J. J., & O’Brien, S. H. (2019). Increased health care utilization and costs during allogeneic hematopoietic cell transplantation for acute leukemia and myelodysplastic syndromes in adolescents and young adults compared with children: A multicenter study. Biology of Blood and Marrow Transplantation, 25(5), 1031–1038.CrossRef
3.
4.
D'Souza, A., Fretham, C. Current uses and outcomes of hematopoietic cell transplantation (HCT): CIBMTR Summary Slides 2019. Retrieved March 9, 2021, from https://​www.​cibmtr.​org
5.
Preussler, J. M., Mau, L. W., Majhail, N. S., Bevans, M., Clancy, E., Messner, C., Parran, L., Pederson, K. A., Ferguson, S. S., Walters, K., & Murphy, E. A. (2019). Caregiver availability and patient access to hematopoietic cell transplantation: Social worker perspectives inform practice. Supportive Care in Cancer, 27(11), 4253–4264.CrossRef
6.
Minculescu, L., Marquart, H. V., Friis, L. S., Petersen, S. L., Schiødt, I., Ryder, L. P., Andersen, N. S., & Sengeloev, H. (2016). Early natural killer cell reconstitution predicts overall survival in T cell–replete allogeneic hematopoietic stem cell transplantation. Biology of Blood and Marrow Transplantation, 22(12), 2187–2193.CrossRef
7.
Wobma, H., Jin, Z., Moscoso, S., Bhatia, M., Broglie, L., George, D., Garvin, J., & Satwani, P. (2020). Risk factors, clinical outcomes, and cost-of-care related to graft failure in pediatric allogeneic hematopoietic cell transplant recipients. Biology of Blood and Marrow Transplantation, 26(7), 1318–1325.CrossRef
8.
Broder, M. S., Quock, T. P., Chang, E., Reddy, S. R., Agarwal-Hashmi, R., Arai, S., & Villa, K. F. (2017). The cost of hematopoietic stem-cell transplantation in the United States. American Health & Drug Benefits, 10(7), 366–374.
9.
Godara, A., Siddiqui, N. S., Munigala, S., Dhawan, R., Kansagra, A. J., Rapoport, A. P., Yared, J. A., & Dahiya, S. (2020). Length of stay and hospital costs for patients undergoing allogeneic stem-cell transplantation. JCO Oncology Practice, 17(3), e355–e368.CrossRef
10.
Kaziunas, E., Hanauer, D. A., Ackerman, M. S., & Choi, S. W. (2016). Identifying unmet informational needs in the inpatient setting to increase patient and caregiver engagement in the context of pediatric hematopoietic stem cell transplantation. Journal of the American Medical Informatics Association, 23(1), 94–104.CrossRef
11.
Brice, L., Weiss, R., Wei, Y., Satwani, P., Bhatia, M., George, D., Garvin, J., Morris, E., Harrison, L., Cairo, M. S., & Sands, S. A. (2011). Health-related quality of life (HRQoL): The impact of medical and demographic variables upon pediatric recipients of hematopoietic stem cell transplantation. Pediatric Blood & Cancer, 57(7), 1179–1185.CrossRef
12.
Loiselle, K. A., Rausch, J. R., Bidwell, S., Drake, S., Davies, S. M., & Pai, A. L. (2016). Predictors of health-related quality of life over time among pediatric hematopoietic stem cell transplant recipients. Pediatric Blood & Cancer, 63(10), 1834–1839.CrossRef
13.
Shaw, B. E., Brazauskas, R., Millard, H. R., Fonstad, R., Flynn, K. E., Abernethy, A., Vogel, J., Petroske, C., Mattila, D., Drexler, R., & Lee, S. J. (2017). Centralized patient-reported outcome data collection in transplantation is feasible and clinically meaningful. Cancer, 123(23), 4687–4700.CrossRef
14.
15.
Clarke, S. A., Skinner, R., Guest, J., Darbyshire, P., Cooper, J., Vora, A., Urquhart, T., Jenney, M., Powell, J., & Eiser, C. (2011). Clinical outcomes and health-related quality of life (HRQOL) following haemopoietic stem cell transplantation (HSCT) for paediatric leukaemia. Child: Care, Health & Development, 37(4), 571–580.
16.
Liu, Y. M., Jaing, T. H., Chen, Y. C., Tang, S. T., Li, C. Y., Wen, Y. C., Chang, H. L., & Chen, M. L. (2016). Quality of life after hematopoietic stem cell transplantation in pediatric survivors: Comparison with healthy controls and risk factors. Cancer Nursing, 39(6), 502–509.CrossRef
17.
Graef, D. M., Phipps, S., Parris, K. R., Martin-Elbahesh, K., Huang, L., Zhang, H., & Crabtree, V. M. (2016). Sleepiness, fatigue, behavioral functioning, and quality of life in survivors of childhood hematopoietic stem cell transplant. Journal of Pediatric Psychology, 41(6), 600–609.CrossRef
18.
Lawitschka, A., Güclü, E., Varni, J., Putz, M., Wolff, D., Pavletic, S., Greinix, H., Peters, C., & Felder-Puig, R. (2014). Health-related quality of life in pediatric patients after allogeneic SCT: Development of the PedsQL stem cell transplant module and results of a pilot study. Bone Marrow Transplantation, 49(8), 1093–1097.CrossRef
19.
Rodgers, C., Wills-Bagnato, P., Sloane, R., & Hockenberry, M. (2015). Health-related quality of life among children and adolescents during hematopoietic stem cell transplant recovery. Journal of Pediatric Oncology Nursing, 32(5), 329–336.CrossRef
20.
Rodday, A. M., Terrin, N., Leslie, L. K., Graham, R. J., & Parsons, S. K. (2017). Understanding the relationship between child health-related quality of life and parent emotional functioning in pediatric hematopoietic stem cell transplant. Journal of Pediatric Psychology, 42(7), 804–814.CrossRef
21.
Rodday, A. M., Terrin, N., Chang, G., & Parsons, S. K. (2013). Performance of the parent emotional functioning (PREMO) screener in parents of children undergoing hematopoietic stem cell transplantation. Quality of Life Research, 22(6), 1427–1433.CrossRef
22.
Rodday, A. M., Terrin, N., & Parsons, S. K. (2013). Measuring global health-related quality of life in children undergoing hematopoietic stem cell transplant: A longitudinal study. Health and Quality of Life Outcomes, 11(1), 26.CrossRef
23.
Terrin, N., Rodday, A. M., & Parsons, S. K. (2015). Joint models for predicting transplant-related mortality from quality of life data. Qual of Life Research, 24(1), 31–39.CrossRef
24.
Johnston, D. L., Nagarajan, R., Caparas, M., Schulte, F., Cullen, P., Aplenc, R., & Sung, L. (2013). Reasons for non-completion of health related quality of life evaluations in pediatric acute myeloid leukemia: A report from the children’s oncology group. PLoS ONE, 8(9), e74549.CrossRef
25.
Parsons, S. K., Tighiouart, H., & Terrin, N. (2013). Assessment of health-related quality of life in pediatric hematopoietic stem cell transplant recipients: Progress, challenges and future directions. Expert Review of Pharmacoeconomics & Outcomes Research, 13(2), 217–225.CrossRef
26.
Wood, W. A., Le-Rademacher, J., Syrjala, K. L., Jim, H., Jacobsen, P. B., Knight, J. M., Abidi, M. H., Wingard, J. R., Majhail, N. S., Geller, N. L., & Rizzo, J. D. (2016). Patient-reported physical functioning predicts the success of hematopoietic cell transplantation (BMT CTN 0902). Cancer, 122(1), 91–98.CrossRef
27.
Schwimmer, J. B., Burwinkle, T. M., & Varni, J. W. (2003). Health-related quality of life of severely obese children and adolescents. JAMA, 289(14), 1813–1819.CrossRef
28.
Varni, J. W., Burwinkle, T. M., & Seid, M. (2005). The PedsQLTM as a pediatric patient-reported outcome: Reliability and validity of the PedsQLTM Measurement Model in 25,000 children. Expert Review of Pharmacoeconomics & Outcomes Research, 5(6), 705–719.CrossRef
29.
Varni, J. W., Burwinkle, T. M., Seid, M., & Skarr, D. (2003). The PedsQLTM* 4.0 as a pediatric population health measure: Feasibility, reliability, and validity. Ambulatory Pediatrics, 3(6), 329–341.CrossRef
30.
Liu, Y. M., Wen, Y. C., Weng, P. Y., Jaing, T. H., & Chen, S. H. (2020). Effectiveness of a three-stage intervention in reducing caregiver distress during pediatric hematopoietic stem cell transplantation: A randomized controlled trial. Journal of Pediatric Oncology Nursing, 37(6), 377–389.CrossRef
31.
Gyurkocza, B., & Sandmaier, B. M. (2014). Conditioning regimens for hematopoietic cell transplantation: One size does not fit all. Blood, 124(3), 344–353.CrossRef
32.
Przepiorka, D., Weisdorf, D., Martin, P., Klingemann, H., Beatty, P., Hows, J., & Thomas, E. D. (1995). 1994 Consensus conference on acute GVHD grading. Bone Marrow Transplantation, 15(6), 825–828.PubMed
33.
34.
Vetter, T. R. (2017). Fundamentals of research data and variables: The devil is in the details. Anesthesia & Analgesia, 125(4), 1375–1380.CrossRef
35.
Bursac, Z., Gauss, C. H., Williams, D. K., & Hosmer, D. W. (2008). Purposeful selection of variables in logistic regression. Source Code for Biology and Medicine, 3(1), 17.CrossRef
36.
Leys, C., Klein, O., Dominicy, Y., & Ley, C. (2018). Detecting multivariate outliers: Use a robust variant of the mahalanobis distance. Journal of Experimental Social Psychology, 74, 150–156.CrossRef
37.
Cox, D. R. (1972). Regression models and life-tables. Journal of the Royal Statistical Society, 34(2), 187–202.
38.
Bishara, A. J., & Hittner, J. B. (2012). Testing the significance of a correlation with nonnormal data: Comparison of Pearson, Spearman, transformation, and resampling approaches. Psychological Methods, 17(3), 399–417.CrossRef
39.
Martin, P. J., Rizzo, J. D., Wingard, J. R., Ballen, K., Curtin, P. T., Cutler, C., Litzow, M. R., Nieto, Y., Savani, B. N., Schriber, J. R., & Shaughnessy, P. J. (2012). First-and second-line systemic treatment of acute graft-versus-host disease: Recommendations of the American Society of Blood and Marrow Transplantation. Biology of Blood and Marrow Transplantation, 18(8), 1150–1163.CrossRef
40.
Jamil, M. O., & Mineishi, S. (2015). State-of-the-art acute and chronic GVHD treatment. International Journal of Hematology, 101(5), 452–466.CrossRef
41.
Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). . Lawrence Erlbaum.
42.
Chow, S., Shao, J., & Wang, H. (2008). Sample size calculations in clinical research (2nd ed.). . CRC Press.
Metadata
Title
Health-related quality of life predicts length of hospital stay and survival rates for pediatric patients receiving allogeneic hematopoietic cell transplantation
Authors
Ying-Mei Liu
Tang-Her Jaing
Yu-Chuan Wen
Shih-Hsiang Chen
Pei-Yin Weng
Lin Lin
Chia-Ling Wu
Publication date
01-12-2021
Publisher
Springer International Publishing
Published in
Quality of Life Research / Issue 12/2021
Print ISSN: 0962-9343
Electronic ISSN: 1573-2649
DOI
https://doi.org/10.1007/s11136-021-02887-1

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