Pre-transplant marital status and hematopoietic cell transplantation outcomes

J. Tay; S. Beattie; C. Bredeson; R. Brazauskas; N. He; I.A. Ahmed; M. Aljurf; M. Askar; Y. Atsuta; S. Badawy; A. Barata; A.M. Beitinjaneh; N.S. Bhatt; D. Buchbinder; J. Cerny; S. Ciurea; A. D'Souza; J. Dalal; N. Farhadfar; C.O. Freytes; S. Ganguly; U. Gergis; S. Gerull; H.M. Lazarus; T. Hahn; S. Hong; Y. Inamoto; N. Khera; T. Kindwall-Keller; R.T. Kamble; J.M. Knight; Y.N. Koleva; A. Kumar; J. Kwok; H.S. Murthy; R.F. Olsson; M.A. Diaz-Perez; D. Rizzieri; S. Seo; S. Chhabra; H. Schoemans; H.C. Schouten; A. Steinberg; K.M. Sullivan; J. Szer; D. Szwajcer; M.L. Ulrickson; L.F. Verdonck; B. Wirk; W.A. Wood

doi:10.3747/co.27.6327

Pre-transplant marital status and hematopoietic cell transplantation outcomes

J. Tay^*, S. Beattie, C. Bredeson, R. Brazauskas, N. He, I.A. Ahmed, M. Aljurf, M. Askar, Y. Atsuta, S. Badawy, A. Barata, A.M. Beitinjaneh, N.S. Bhatt, D. Buchbinder, J. Cerny, S. Ciurea, A. D'Souza, J. Dalal, N. Farhadfar, C.O. FreytesS. Ganguly, U. Gergis, S. Gerull, H.M. Lazarus, T. Hahn, S. Hong, Y. Inamoto, N. Khera, T. Kindwall-Keller, R.T. Kamble, J.M. Knight, Y.N. Koleva, A. Kumar, J. Kwok, H.S. Murthy, R.F. Olsson, M.A. Diaz-Perez, D. Rizzieri, S. Seo, S. Chhabra, H. Schoemans, H.C. Schouten, A. Steinberg, K.M. Sullivan, J. Szer, D. Szwajcer, M.L. Ulrickson, L.F. Verdonck, B. Wirk, W.A. Wood

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

1 Citation (Web of Science)

Abstract

Background Evidence about the impact of marital status before hematopoietic cell transplantation (HCT) on outcomes after HCT is conflicting.Methods We identified patients 40 years of age and older within the Center for International Blood and Marrow Transplant Research registry who underwent HCT between January 2008 and December 2015. Marital status before HCT was declared as one of: married or living with a partner, single (never married), separated or divorced, and widowed. We performed a multivariable analysis to determine the association of marital status with outcomes after HCT.Results We identified 10,226 allogeneic and 5714 autologous HCT cases with, respectively, a median follow-up of 37 months (range: 1-102 months) and 40 months (range: 1-106 months). No association between marital status and overall survival was observed in either the allogeneic (p = 0.58) or autologous (p = 0.17) setting. However, marital status was associated with grades 2-4 acute graft-versus-host disease (GVHD), p < 0.001, and chronic GVHD, p = 0.04. The risk of grades 2-4 acute GVHD was increased in separated compared with married patients [hazard ratio (FIR): 1.13; 95% confidence interval (CI): 1.03 to 1.24], and single patients had a reduced risk of grades 2-4 acute GVHD (FIR: 0.87; 95% CI: 0.77 to 0.98). The risk of chronic GVHD was lower in widowed compared with married patients (FIR: 0.82; 95% CI: 0.67 to 0.99).Conclusions Overall survival after HCT is not influenced by marital status, but associations were evident between marital status and grades 2-4 acute and chronic GVHD. To better appreciate the effects of marital status and social support, future research should consider using validated scales to measure social support and patient and caregiver reports of caregiver commitment, and to assess health-related quality of life together with health care utilization.

Original language	English
Pages (from-to)	E596-E606
Number of pages	11
Journal	Current Oncology
Volume	27
Issue number	6
DOIs	https://doi.org/10.3747/co.27.6327
Publication status	Published - 1 Dec 2020

Keywords

blood
cancer-patients
caregivers
clinical-outcomes
graft-versus-host disease
hematopoietic cell transplantation
impact
insurance
marital status
overall survival
patient-reported outcomes
registries
social support
socioeconomic-status
survival
SURVIVAL
INSURANCE
Hematopoietic cell transplantation
CANCER-PATIENTS
SOCIAL SUPPORT
CLINICAL-OUTCOMES
BLOOD
PATIENT-REPORTED OUTCOMES
IMPACT
SOCIOECONOMIC-STATUS
CAREGIVERS

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Cite this

Tay, J., Beattie, S., Bredeson, C., Brazauskas, R., He, N., Ahmed, I. A., Aljurf, M., Askar, M., Atsuta, Y., Badawy, S., Barata, A., Beitinjaneh, A. M., Bhatt, N. S., Buchbinder, D., Cerny, J., Ciurea, S., D'Souza, A., Dalal, J., Farhadfar, N., ... Wood, W. A. (2020). Pre-transplant marital status and hematopoietic cell transplantation outcomes. Current Oncology, 27(6), E596-E606. https://doi.org/10.3747/co.27.6327

@article{5ef3c163338340a18f240e74f60f7f2e,

title = "Pre-transplant marital status and hematopoietic cell transplantation outcomes",

abstract = "Background Evidence about the impact of marital status before hematopoietic cell transplantation (HCT) on outcomes after HCT is conflicting.Methods We identified patients 40 years of age and older within the Center for International Blood and Marrow Transplant Research registry who underwent HCT between January 2008 and December 2015. Marital status before HCT was declared as one of: married or living with a partner, single (never married), separated or divorced, and widowed. We performed a multivariable analysis to determine the association of marital status with outcomes after HCT.Results We identified 10,226 allogeneic and 5714 autologous HCT cases with, respectively, a median follow-up of 37 months (range: 1-102 months) and 40 months (range: 1-106 months). No association between marital status and overall survival was observed in either the allogeneic (p = 0.58) or autologous (p = 0.17) setting. However, marital status was associated with grades 2-4 acute graft-versus-host disease (GVHD), p < 0.001, and chronic GVHD, p = 0.04. The risk of grades 2-4 acute GVHD was increased in separated compared with married patients [hazard ratio (FIR): 1.13; 95% confidence interval (CI): 1.03 to 1.24], and single patients had a reduced risk of grades 2-4 acute GVHD (FIR: 0.87; 95% CI: 0.77 to 0.98). The risk of chronic GVHD was lower in widowed compared with married patients (FIR: 0.82; 95% CI: 0.67 to 0.99).Conclusions Overall survival after HCT is not influenced by marital status, but associations were evident between marital status and grades 2-4 acute and chronic GVHD. To better appreciate the effects of marital status and social support, future research should consider using validated scales to measure social support and patient and caregiver reports of caregiver commitment, and to assess health-related quality of life together with health care utilization.",

keywords = "blood, cancer-patients, caregivers, clinical-outcomes, graft-versus-host disease, hematopoietic cell transplantation, impact, insurance, marital status, overall survival, patient-reported outcomes, registries, social support, socioeconomic-status, survival, SURVIVAL, INSURANCE, Hematopoietic cell transplantation, CANCER-PATIENTS, SOCIAL SUPPORT, CLINICAL-OUTCOMES, BLOOD, PATIENT-REPORTED OUTCOMES, IMPACT, SOCIOECONOMIC-STATUS, CAREGIVERS",

author = "J. Tay and S. Beattie and C. Bredeson and R. Brazauskas and N. He and I.A. Ahmed and M. Aljurf and M. Askar and Y. Atsuta and S. Badawy and A. Barata and A.M. Beitinjaneh and N.S. Bhatt and D. Buchbinder and J. Cerny and S. Ciurea and A. D'Souza and J. Dalal and N. Farhadfar and C.O. Freytes and S. Ganguly and U. Gergis and S. Gerull and H.M. Lazarus and T. Hahn and S. Hong and Y. Inamoto and N. Khera and T. Kindwall-Keller and R.T. Kamble and J.M. Knight and Y.N. Koleva and A. Kumar and J. Kwok and H.S. Murthy and R.F. Olsson and M.A. Diaz-Perez and D. Rizzieri and S. Seo and S. Chhabra and H. Schoemans and H.C. Schouten and A. Steinberg and K.M. Sullivan and J. Szer and D. Szwajcer and M.L. Ulrickson and L.F. Verdonck and B. Wirk and W.A. Wood",

note = "Funding Information: The cibmtr is supported primarily by Public Health Service U24CA076518 from the U.S. National Cancer Institute (nci); the U.S. National Heart, Lung, and Blood Institute (nhlbi); and the U.S. National Institute of Allergy and Infectious Diseases; U24HL138660 from the nhlbi and the nci; OT3HL147741, and U01HL128568 from the nhlbi; HHSH250201700006C and HHSH250201700007C from the Health Resources and Services Administration (hrsa); and N00014-18-1-2850, N00014-18-1-2888, and N00014-20-1-2705 from the U.S. Office of Naval Research. Additional federal support is provided by P01CA111412, R01CA152108, R01CA215134, R01CA218285, R01CA231141, R01AI128775, R01HL126589, R01HL129472, R01HL130388, R01HL131731, U01AI069197, U01AI126612, and the U.S. Biomedical Advanced Research and Development Authority. Support is also provided by Be the Match Foundation, Boston Children{\textquoteright}s Hospital, Dana–Farber, St. Baldrick{\textquoteright}s Foundation, Stanford University, the Medical College of Wisconsin, the U.S. National Marrow Donor Program, and the following commercial entities: AbbVie; Actinium Pharmaceuticals, Inc.; Adaptive Biotechnologies; Adienne sa; Allovir; Amgen; Angiocrine Bioscience; Astellas Pharma US; AstraZeneca; Atara Biotherapeutics; bluebird bio; Bristol Myers Squibb; Celgene; cslBehring;CytoSenTherapeutics; Daiichi Sankyo; Gamida-Cell; Genentech; HistoGenetics; Incyte Corporation; Janssen Biotech; Jazz Pharmaceuticals; Johnson and Johnson; Kiadis Pharma; Kite, a Gilead Company; Kyowa Kirin; Legend Biotech; Magenta Therapeutics; Mallinckrodt llc; Merck and Company; Merck Sharp and Dohme; Millennium: The Takeda Oncology Company; Miltenyi Biotec; Novartis Pharmaceuticals; Omeros Corporation; Oncoimmune; Orca Biosystems; Pfizer; Pharmacyclics llc; Sanofi Genzyme; Shire; Sobi; StemCyte; Takeda Pharma; Terumo bct; Viracor Eurofins; Vor Bio Pharma; Xenikos bv. The views expressed in this article do not reflect the official policy or position of the U.S. National Institute of Health, the U.S. Department of the Navy, the U.S. Department of Defense, the hrsa, or any other agency of the U.S. Government. The cibmtr supports accessibility of research in accord with the Data Sharing Policy of the U.S. National Institutes of Health and Cancer Moonshot Public Access and Data Sharing Policy of the U.S. National Cancer Institute. The cibmtr releases only de-identified datasets that comply with all relevant global regulations regarding privacy and confidentiality. Funding Information: The cibmtr is supported primarily by Public Health Service U24CA076518 from the U.S. National Cancer Institute (nci); the U.S. National Heart, Lung, and Blood Institute (nhlbi); and the U.S. National Institute of Allergy and Infectious Diseases; U24HL138660 from the nhlbi and the nci; OT3HL147741, and U01HL128568 from the nhlbi; HHSH250201700006C and HHSH250201700007C from the Health Resources and Services Administration (hrsa); and N00014-18-1-2850, N00014-18-1-2888, and N00014-20-1-2705 from the U.S. Office of Naval Research. Additional federal support is provided by P01CA111412, R01CA152108, R01CA215134, R01CA218285, R01CA231141, R01AI128775, R01HL126589, R01HL129472, R01HL130388, R01HL131731, U01AI069197, U01AI126612, and the U.S. Biomedical Advanced Research and Development Authority. Support is also provided by Be the Match Foundation, Boston Children?s Hospital, Dana?Farber, St. Baldrick?s Foundation, Stanford University, the Medical College of Wisconsin, the U.S. National Marrow Donor Program, and the following commercial entities: AbbVie; Actinium Pharmaceuticals, Inc.; Adaptive Biotechnologies; Adienne sa; Allovir; Amgen; Angiocrine Bioscience; Astellas Pharma US; AstraZeneca; Atara Biotherapeutics; bluebird bio; Bristol Myers Squibb; Celgene; csl Behring; CytoSen Therapeutics; Daiichi Sankyo; Gamida-Cell; Genentech; HistoGenetics; Incyte Corporation; Janssen Biotech; Jazz Pharmaceuticals; Johnson and Johnson; Kiadis Pharma; Kite, a Gilead Company; Kyowa Kirin; Legend Biotech; Magenta Therapeutics; Mallinckrodt llc; Merck and Company; Merck Sharp and Dohme; Millennium: The Takeda Oncology Company; Miltenyi Biotec; Novartis Pharmaceuticals; Omeros Corporation; Oncoimmune; Orca Biosystems; Pfizer; Pharmacyclics llc; Sanofi Genzyme; Shire; Sobi; StemCyte; Takeda Pharma; Terumo bct; Viracor Eurofins; Vor Bio Pharma; Xenikos bv. The views expressed in this article do not reflect the official policy or position of the U.S. National Institute of Health, the U.S. Department of the Navy, the U.S. Department of Defense, the hrsa, or any other agency of the U.S. Government. The cibmtr supports accessibility of research in accord with the Data Sharing Policy of the U.S. National Institutes of Health and Cancer Moonshot Public Access and Data Sharing Policy of the U.S. National Cancer Institute. The cibmtr releases only de-identified datasets that comply with all relevant global regulations regarding privacy and confidentiality. Publisher Copyright: {\textcopyright} 2020 Multimed Inc.",

year = "2020",

month = dec,

day = "1",

doi = "10.3747/co.27.6327",

language = "English",

volume = "27",

pages = "E596--E606",

journal = "Current Oncology",

issn = "1198-0052",

publisher = "Multimed Inc.",

number = "6",

}

Tay, J, Beattie, S, Bredeson, C, Brazauskas, R, He, N, Ahmed, IA, Aljurf, M, Askar, M, Atsuta, Y, Badawy, S, Barata, A, Beitinjaneh, AM, Bhatt, NS, Buchbinder, D, Cerny, J, Ciurea, S, D'Souza, A, Dalal, J, Farhadfar, N, Freytes, CO, Ganguly, S, Gergis, U, Gerull, S, Lazarus, HM, Hahn, T, Hong, S, Inamoto, Y, Khera, N, Kindwall-Keller, T, Kamble, RT, Knight, JM, Koleva, YN, Kumar, A, Kwok, J, Murthy, HS, Olsson, RF, Diaz-Perez, MA, Rizzieri, D, Seo, S, Chhabra, S, Schoemans, H, Schouten, HC, Steinberg, A, Sullivan, KM, Szer, J, Szwajcer, D, Ulrickson, ML, Verdonck, LF, Wirk, B & Wood, WA 2020, 'Pre-transplant marital status and hematopoietic cell transplantation outcomes', Current Oncology, vol. 27, no. 6, pp. E596-E606. https://doi.org/10.3747/co.27.6327

TY - JOUR

T1 - Pre-transplant marital status and hematopoietic cell transplantation outcomes

AU - Tay, J.

AU - Beattie, S.

AU - Bredeson, C.

AU - Brazauskas, R.

AU - He, N.

AU - Ahmed, I.A.

AU - Aljurf, M.

AU - Askar, M.

AU - Atsuta, Y.

AU - Badawy, S.

AU - Barata, A.

AU - Beitinjaneh, A.M.

AU - Bhatt, N.S.

AU - Buchbinder, D.

AU - Cerny, J.

AU - Ciurea, S.

AU - D'Souza, A.

AU - Dalal, J.

AU - Farhadfar, N.

AU - Freytes, C.O.

AU - Ganguly, S.

AU - Gergis, U.

AU - Gerull, S.

AU - Lazarus, H.M.

AU - Hahn, T.

AU - Hong, S.

AU - Inamoto, Y.

AU - Khera, N.

AU - Kindwall-Keller, T.

AU - Kamble, R.T.

AU - Knight, J.M.

AU - Koleva, Y.N.

AU - Kumar, A.

AU - Kwok, J.

AU - Murthy, H.S.

AU - Olsson, R.F.

AU - Diaz-Perez, M.A.

AU - Rizzieri, D.

AU - Seo, S.

AU - Chhabra, S.

AU - Schoemans, H.

AU - Schouten, H.C.

AU - Steinberg, A.

AU - Sullivan, K.M.

AU - Szer, J.

AU - Szwajcer, D.

AU - Ulrickson, M.L.

AU - Verdonck, L.F.

AU - Wirk, B.

AU - Wood, W.A.

N1 - Funding Information: The cibmtr is supported primarily by Public Health Service U24CA076518 from the U.S. National Cancer Institute (nci); the U.S. National Heart, Lung, and Blood Institute (nhlbi); and the U.S. National Institute of Allergy and Infectious Diseases; U24HL138660 from the nhlbi and the nci; OT3HL147741, and U01HL128568 from the nhlbi; HHSH250201700006C and HHSH250201700007C from the Health Resources and Services Administration (hrsa); and N00014-18-1-2850, N00014-18-1-2888, and N00014-20-1-2705 from the U.S. Office of Naval Research. Additional federal support is provided by P01CA111412, R01CA152108, R01CA215134, R01CA218285, R01CA231141, R01AI128775, R01HL126589, R01HL129472, R01HL130388, R01HL131731, U01AI069197, U01AI126612, and the U.S. Biomedical Advanced Research and Development Authority. Support is also provided by Be the Match Foundation, Boston Children’s Hospital, Dana–Farber, St. Baldrick’s Foundation, Stanford University, the Medical College of Wisconsin, the U.S. National Marrow Donor Program, and the following commercial entities: AbbVie; Actinium Pharmaceuticals, Inc.; Adaptive Biotechnologies; Adienne sa; Allovir; Amgen; Angiocrine Bioscience; Astellas Pharma US; AstraZeneca; Atara Biotherapeutics; bluebird bio; Bristol Myers Squibb; Celgene; cslBehring;CytoSenTherapeutics; Daiichi Sankyo; Gamida-Cell; Genentech; HistoGenetics; Incyte Corporation; Janssen Biotech; Jazz Pharmaceuticals; Johnson and Johnson; Kiadis Pharma; Kite, a Gilead Company; Kyowa Kirin; Legend Biotech; Magenta Therapeutics; Mallinckrodt llc; Merck and Company; Merck Sharp and Dohme; Millennium: The Takeda Oncology Company; Miltenyi Biotec; Novartis Pharmaceuticals; Omeros Corporation; Oncoimmune; Orca Biosystems; Pfizer; Pharmacyclics llc; Sanofi Genzyme; Shire; Sobi; StemCyte; Takeda Pharma; Terumo bct; Viracor Eurofins; Vor Bio Pharma; Xenikos bv. The views expressed in this article do not reflect the official policy or position of the U.S. National Institute of Health, the U.S. Department of the Navy, the U.S. Department of Defense, the hrsa, or any other agency of the U.S. Government. The cibmtr supports accessibility of research in accord with the Data Sharing Policy of the U.S. National Institutes of Health and Cancer Moonshot Public Access and Data Sharing Policy of the U.S. National Cancer Institute. The cibmtr releases only de-identified datasets that comply with all relevant global regulations regarding privacy and confidentiality. Funding Information: The cibmtr is supported primarily by Public Health Service U24CA076518 from the U.S. National Cancer Institute (nci); the U.S. National Heart, Lung, and Blood Institute (nhlbi); and the U.S. National Institute of Allergy and Infectious Diseases; U24HL138660 from the nhlbi and the nci; OT3HL147741, and U01HL128568 from the nhlbi; HHSH250201700006C and HHSH250201700007C from the Health Resources and Services Administration (hrsa); and N00014-18-1-2850, N00014-18-1-2888, and N00014-20-1-2705 from the U.S. Office of Naval Research. Additional federal support is provided by P01CA111412, R01CA152108, R01CA215134, R01CA218285, R01CA231141, R01AI128775, R01HL126589, R01HL129472, R01HL130388, R01HL131731, U01AI069197, U01AI126612, and the U.S. Biomedical Advanced Research and Development Authority. Support is also provided by Be the Match Foundation, Boston Children?s Hospital, Dana?Farber, St. Baldrick?s Foundation, Stanford University, the Medical College of Wisconsin, the U.S. National Marrow Donor Program, and the following commercial entities: AbbVie; Actinium Pharmaceuticals, Inc.; Adaptive Biotechnologies; Adienne sa; Allovir; Amgen; Angiocrine Bioscience; Astellas Pharma US; AstraZeneca; Atara Biotherapeutics; bluebird bio; Bristol Myers Squibb; Celgene; csl Behring; CytoSen Therapeutics; Daiichi Sankyo; Gamida-Cell; Genentech; HistoGenetics; Incyte Corporation; Janssen Biotech; Jazz Pharmaceuticals; Johnson and Johnson; Kiadis Pharma; Kite, a Gilead Company; Kyowa Kirin; Legend Biotech; Magenta Therapeutics; Mallinckrodt llc; Merck and Company; Merck Sharp and Dohme; Millennium: The Takeda Oncology Company; Miltenyi Biotec; Novartis Pharmaceuticals; Omeros Corporation; Oncoimmune; Orca Biosystems; Pfizer; Pharmacyclics llc; Sanofi Genzyme; Shire; Sobi; StemCyte; Takeda Pharma; Terumo bct; Viracor Eurofins; Vor Bio Pharma; Xenikos bv. The views expressed in this article do not reflect the official policy or position of the U.S. National Institute of Health, the U.S. Department of the Navy, the U.S. Department of Defense, the hrsa, or any other agency of the U.S. Government. The cibmtr supports accessibility of research in accord with the Data Sharing Policy of the U.S. National Institutes of Health and Cancer Moonshot Public Access and Data Sharing Policy of the U.S. National Cancer Institute. The cibmtr releases only de-identified datasets that comply with all relevant global regulations regarding privacy and confidentiality. Publisher Copyright: © 2020 Multimed Inc.

PY - 2020/12/1

Y1 - 2020/12/1

N2 - Background Evidence about the impact of marital status before hematopoietic cell transplantation (HCT) on outcomes after HCT is conflicting.Methods We identified patients 40 years of age and older within the Center for International Blood and Marrow Transplant Research registry who underwent HCT between January 2008 and December 2015. Marital status before HCT was declared as one of: married or living with a partner, single (never married), separated or divorced, and widowed. We performed a multivariable analysis to determine the association of marital status with outcomes after HCT.Results We identified 10,226 allogeneic and 5714 autologous HCT cases with, respectively, a median follow-up of 37 months (range: 1-102 months) and 40 months (range: 1-106 months). No association between marital status and overall survival was observed in either the allogeneic (p = 0.58) or autologous (p = 0.17) setting. However, marital status was associated with grades 2-4 acute graft-versus-host disease (GVHD), p < 0.001, and chronic GVHD, p = 0.04. The risk of grades 2-4 acute GVHD was increased in separated compared with married patients [hazard ratio (FIR): 1.13; 95% confidence interval (CI): 1.03 to 1.24], and single patients had a reduced risk of grades 2-4 acute GVHD (FIR: 0.87; 95% CI: 0.77 to 0.98). The risk of chronic GVHD was lower in widowed compared with married patients (FIR: 0.82; 95% CI: 0.67 to 0.99).Conclusions Overall survival after HCT is not influenced by marital status, but associations were evident between marital status and grades 2-4 acute and chronic GVHD. To better appreciate the effects of marital status and social support, future research should consider using validated scales to measure social support and patient and caregiver reports of caregiver commitment, and to assess health-related quality of life together with health care utilization.

AB - Background Evidence about the impact of marital status before hematopoietic cell transplantation (HCT) on outcomes after HCT is conflicting.Methods We identified patients 40 years of age and older within the Center for International Blood and Marrow Transplant Research registry who underwent HCT between January 2008 and December 2015. Marital status before HCT was declared as one of: married or living with a partner, single (never married), separated or divorced, and widowed. We performed a multivariable analysis to determine the association of marital status with outcomes after HCT.Results We identified 10,226 allogeneic and 5714 autologous HCT cases with, respectively, a median follow-up of 37 months (range: 1-102 months) and 40 months (range: 1-106 months). No association between marital status and overall survival was observed in either the allogeneic (p = 0.58) or autologous (p = 0.17) setting. However, marital status was associated with grades 2-4 acute graft-versus-host disease (GVHD), p < 0.001, and chronic GVHD, p = 0.04. The risk of grades 2-4 acute GVHD was increased in separated compared with married patients [hazard ratio (FIR): 1.13; 95% confidence interval (CI): 1.03 to 1.24], and single patients had a reduced risk of grades 2-4 acute GVHD (FIR: 0.87; 95% CI: 0.77 to 0.98). The risk of chronic GVHD was lower in widowed compared with married patients (FIR: 0.82; 95% CI: 0.67 to 0.99).Conclusions Overall survival after HCT is not influenced by marital status, but associations were evident between marital status and grades 2-4 acute and chronic GVHD. To better appreciate the effects of marital status and social support, future research should consider using validated scales to measure social support and patient and caregiver reports of caregiver commitment, and to assess health-related quality of life together with health care utilization.

KW - blood

KW - cancer-patients

KW - caregivers

KW - clinical-outcomes

KW - graft-versus-host disease

KW - hematopoietic cell transplantation

KW - impact

KW - insurance

KW - marital status

KW - overall survival

KW - patient-reported outcomes

KW - registries

KW - social support

KW - socioeconomic-status

KW - survival

KW - SURVIVAL

KW - INSURANCE

KW - Hematopoietic cell transplantation

KW - CANCER-PATIENTS

KW - SOCIAL SUPPORT

KW - CLINICAL-OUTCOMES

KW - BLOOD

KW - PATIENT-REPORTED OUTCOMES

KW - IMPACT

KW - SOCIOECONOMIC-STATUS

KW - CAREGIVERS

U2 - 10.3747/co.27.6327

DO - 10.3747/co.27.6327

M3 - Article

C2 - 33380875

SN - 1198-0052

VL - 27

SP - E596-E606

JO - Current Oncology

JF - Current Oncology

IS - 6

ER -