Health-Related Quality of Life Outcomes in Older Hematopoietic Cell Transplantation Survivors

Sanghee Hong, Jing Zhao, Shu Wang, Han Wang, Ji Hyun Lee, Nosha Farhadfar, Joseph P. McGuirk, Bipin N. Savani, Hashmi K. Shahrukh, Patrick Stiff, Nandita Khera, Theresa Hahn, Alison W. Loren, Samantha M. Jaglowski, William A. Wood, Wael Saber, Jan Cerny, Shernan G. Holtan, Jana M. Reynolds, Abhinav DeolHeather Jim, Joseph Uberti, Victoria Whalen, Jean C. Yi, Jaime Preussler, K. Scott Baker, Bronwen E. Shaw, Steven Devine, Karen Syrjala, Navneet S. Majhail, John R. Wingard, Zeina Al-Mansour

Research output: Contribution to journalArticlepeer-review


The use of hematopoietic cell transplantation (HCT) has been increasing in older patients. However, the levels if distress, psychosocial functioning, and health-related quality of life (HRQOL) among older HCT survivors remains largely unknown. In this secondary analysis using data from 2 randomized controlled trials, we analyzed baseline Cancer and Treatment Distress (CTXD) and Confidence In Survivorship Information (CSI) surveys of HCT survivors who were age ≥60 years at the time of transplantation and alive and disease-free ≥1 year post-autologous or -allogeneic HCT. We analyzed associations of these parameters with the Physical Component Summary (PCS) and Mental Component Summary (MCS) scores of the 12-Item Short Form Survey (SF-12) and a healthcare adherence (HCA) scale, after adjusting for transplantation and patient demographic factors. A total of 567 patients were included. The median patient age at HCT was 65 years, and 68% of the patients underwent autologous HCT. The median CTXD score was .7 (mild), and the greatest distress was reported in the “health burden” subscale. The median CSI score was 1.4 (moderate-high), with the lowest confidence reported in the “late effects” subscale. We found negative Spearman correlations between CTXD score and SF-12 PCS (P = -.59) and MCS (P = -.54) and positive Spearman correlations between CSI score and SF-12 PCS (P = .23) and MCS (P = .30). The median HCA scale score was high at .8. Male sex, autologous HCT, increased distress level, and worse CSI score were associated with lower use of preventive care. Older survivors experienced a low level of distress and moderate-high level of CSI at ≥1 year post-HCT. As lower distress and higher CSI were associated with improved HRQOL and optimized preventive HCA, CTXD/CSI measures can be used to individualize the care of older adult HCT survivors.

Original languageEnglish (US)
Pages (from-to)202.e1-202.e8
JournalTransplantation and Cellular Therapy
Issue number3
StatePublished - Mar 2023

Bibliographical note

Funding Information:
Financial disclosure: Data used in these analyses were obtained from the Fred Hutchinson Cancer Research Center INSPIRE study funded by National Cancer Institute (NCI) Grants R01 CA160684 and R01 CA21513 and from the PCORI-SCP study funded through a National Marrow Donor Program/Be The Match Patient-Centered Outcomes Research Institute (PCORI) Award ( CD-12-11-4062 ). The views in this publication are solely the responsibility of the authors and do not necessarily represent the views of the PCORI, its Board of Governors or Methodology Committee, or the NCI.

Publisher Copyright:
© 2022


  • Cancer and Treatment Distress
  • Confidence in Survivorship Information
  • Elderly
  • Healthcare adherence
  • Hematopoietic cell transplantation
  • Quality of life


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