The prognostic value of patient-reported outcomes in allogeneic hematopoietic stem cell transplantation: exploratory analysis of a randomized nutrition intervention trial.

Anne Marte Gudmundstuen, Fabio Efficace, Geir Erland Tjønnfjord, Kristin Joan Skaarud, Francesco Cottone, Marianne Jensen Hjermstad, Per Ole Iversen

Journal: Annals of hematology 2023;102(4):927-935

PMID: 36864210

Abstract

Whether patient-reported outcomes (PROs) can predict overall survival (OS) and non-relapse mortality (NRM) among recipients of allogeneic stem cell transplantation (allo-HSCT), is unclear. We performed an exploratory analysis of the prognostic value of patient-reported outcomes (PROs) among 117 recipients of allogeneic stem cell transplantation (allo-HSCT) who participated in a randomized nutrition intervention trial. Cox proportional hazards models were used to investigate possible associations between PROs collected pre-allo-HSCT (baseline) using scores from the EORTC Quality of Life Questionnaire-Core 30 (QLQ-C30) and 1-year overall survival (OS), whereas logistic regression was used to study associations between these PROs and 1-year non-relapse mortality (NRM). Multivariable analyses indicated that only the Hematopoietic Cell Transplantation Comorbidity Index (HCT-CI) and the European Bone Marrow Transplantation (EBMT) risk score were associated with 1-year OS. In the multivariable model including clinical-sociodemographic factors for 1-year NRM, our analysis showed that living alone (p=0.009), HCT-CI (p=0.016), EBMT risk score (p=0.002), and stem cell source (p=0.046) could be associated with 1-year NRM. Moreover, in the multivariable model, our analysis showed that only appetite loss from the QLQ-C30 was associated with 1-year NRM (p=0.026). In conclusion, in this specific setting, our analysis suggests that the commonly used HCT-CI and EBMT risk scores could be predictive for both 1-year OS and 1-year NRM, whereas baseline PROs in general were not.

© 2023. The Author(s).

Address: Department of Haematology, Oslo University Hospital, 4950 Nydalen, NO-0424, Oslo, Norway. [email protected].; Department of Nutrition, Institute of Basic Medical Science, University of Oslo, Oslo, Norway. [email protected].; Italian Group for Adult Hematologic Diseases (GIMEMA), Data Centre and Health Outcomes Research Unit, Rome, Italy.; Department of Haematology, Oslo University Hospital, 4950 Nydalen, NO-0424, Oslo, Norway.; K.G. Jebsen Centre for B Cell Malignancies, University of Oslo, Oslo, Norway.; Institute of Clinical Medicine, University of Oslo, Oslo, Norway.; Department of Haematology, Oslo University Hospital, 4950 Nydalen, NO-0424, Oslo, Norway.; Lovisenberg Diaconal University College, Oslo, Norway.; European Palliative Care Research Centre (PRC) Department of Oncology Oslo University Hospital/Institute of Clinical Medicine, University of Oslo, Oslo, Norway.; Regional Advisory Unit for Palliative Care, Department of Oncology, Oslo University Hospital, Oslo, Norway.; Department of Haematology, Oslo University Hospital, 4950 Nydalen, NO-0424, Oslo, Norway.; Department of Nutrition, Institute of Basic Medical Science, University of Oslo, Oslo, Norway.
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