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Post‐transplantation employment status of adult survivors of childhood allogeneic hematopoietic cell transplant: A report from the Center for International Blood and Marrow Transplant Research (CIBMTR)
Author(s) -
Bhatt Neel S.,
Brazauskas Ruta,
Tecca Heather R.,
Carreras Jeanette,
Burns Linda J.,
Phelan Rachel,
Salit Rachel B.,
Syrjala Karen L.,
Talano JulieAn M.,
Shaw Bronwen E.
Publication year - 2019
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.31781
Subject(s) - medicine , transplantation , hazard ratio , total body irradiation , confidence interval , hematopoietic cell , young adult , hematopoietic stem cell transplantation , pediatrics , surgery , demography , haematopoiesis , stem cell , chemotherapy , biology , sociology , genetics , cyclophosphamide
Background Data are scarce regarding employment outcomes of survivors of childhood allogeneic hematopoietic cell transplantation (alloHCT) and the factors that affect their employment status. Methods By using the Center for International Blood and Marrow Transplant Research database, the authors studied employment outcomes of ≥1‐year survivors of childhood alloHCT who were age ≥18 years at their most recent assessment (year of transplantation, 1985‐2010). Employment status was assessed at their attained ages (ages 18‐22, 23‐27, and 28‐32 years) and according to transplantation center (TC) location (United States or International). A multivariable analysis assessing the factors that affected employed status (full‐time/part‐time work or student) was performed. Results Unemployment rates among 2844 survivors were persistently high at all attained ages (United States TCs: ages 18‐22 [14%], 23‐27 [15%], and 28‐32 [13%] years; International TCs: ages 18‐22 [56%], 23‐27 [53%], and 28‐32 [68%] years). The factors associated a with higher likelihood of employment included: older age at alloHCT (ages 5‐9‐years: hazard ratio [HR], 2.07; 95% confidence interval [CI], 1.65‐2.6; ages 10‐14 years: HR, 4.43; 95% CI, 3.58‐5.47; ages 15‐18‐years: HR, 7.13; 95% CI, 5.72‐8.88), myeloablative conditioning without total body irradiation (TBI) (HR, 1.56; 95% CI, 1.38‐1.77), reduced‐intensity conditioning with TBI (HR, 1.47; 95% CI, 1.19‐1.8) or without TBI (HR, 2.51; 95% CI, 2.15‐2.92), and US‐based TC (HR, 1.84; 95% CI, 1.62‐2.08). Conclusions Young adult survivors of childhood alloHCT have high unemployment rates at all studied attained ages after HCT. Future efforts should be directed toward understanding the causes of unemployment their and relation to quality of life using patient‐reported outcome measures.