Premium
Pain in older survivors of hematologic malignancies after blood or marrow transplantation: A BMTSS report
Author(s) -
Farrukh Naveed,
Hageman Lindsey,
Chen Yanjun,
Wu Jessica,
Ness Emily,
Kung Michelle,
Francisco Liton,
Parman Mariel,
Landier Wendy,
Arora Mukta,
Armenian Saro,
Bhatia Smita,
Williams Grant R.
Publication year - 2020
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.32736
Subject(s) - medicine , odds ratio , chronic pain , sibling , hematologic disease , total body irradiation , cohort , physical therapy , disease , chemotherapy , psychology , developmental psychology , cyclophosphamide
Background Blood or marrow transplantation (BMT) is increasingly offered to older adults with hematologic malignancies; however, their risk for severe pain is poorly understood. Using the Bone Marrow Transplant Survivor Study, the current study investigated the prevalence and predictors of pain after BMT (allogeneic or autologous) as well as its association with physical performance impairments and frailty. Methods The cohort included 736 patients with hematologic malignancies who underwent BMT at an age ≥ 60 years at 1 of 3 transplant centers between 1974 and 2014 and survived ≥2 years after BMT; 183 unaffected siblings also participated. Study participants reported on 4 pain domains (nonminor everyday pain, moderate to severe bodily pain, prolonged pain, and moderate to extreme pain interference), and the presence of 1 or more domains was indicative of a severe and/or life‐interfering pain composite variable. Results Overall, 39.4% of the BMT survivors reported severe pain with 2.6‐fold greater odds of reporting pain in comparison with sibling controls. Among BMT recipients, those with less education, lower incomes, and active chronic graft‐versus‐host disease had higher odds of reporting pain. In multivariable analyses, BMT survivors with pain were more likely to have impaired physical performance and were more likely to meet the frailty criteria. BMT survivors reported higher use of pain medications (17.8% vs 9.3%) and opioid pain medications (6.5% vs 2.2%) in comparison with sibling controls. Conclusions Nearly 40% of older BMT survivors who were followed for a median of 5 years after BMT reported pain, and BMT survivors had 2.6‐fold higher odds of reporting severe, nonminor or life‐interfering pain in comparison with siblings.