Predictors of Transplant Regret: A Case–Control Study Nested Within a Prospective Cohort of HSCT Recipients

ABSTRACT Objective To explore pre–hematopoietic stem cell transplant (HSCT) demographic, disease, and psychological factors predictive of future transplant regret and to determine post‐HSCT variables associated with regret. Patients and Methods HSCT candidates participated in a prospective cohort st...

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Main Authors: Janae L. Kirsch, James R. Cerhan, William J. Hogan, Holly C. Edwards, Christi A. Patten, Tabetha Brockman, Christine Hughes, Angela Dispenzieri, Stephen M. Ansell, Dennis A. Gastineau, Shawna L. Ehlers
Format: Article
Language:English
Published: Wiley 2025-04-01
Series:Cancer Medicine
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Online Access:https://doi.org/10.1002/cam4.70828
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author Janae L. Kirsch
James R. Cerhan
William J. Hogan
Holly C. Edwards
Christi A. Patten
Tabetha Brockman
Christine Hughes
Angela Dispenzieri
Stephen M. Ansell
Dennis A. Gastineau
Shawna L. Ehlers
author_facet Janae L. Kirsch
James R. Cerhan
William J. Hogan
Holly C. Edwards
Christi A. Patten
Tabetha Brockman
Christine Hughes
Angela Dispenzieri
Stephen M. Ansell
Dennis A. Gastineau
Shawna L. Ehlers
author_sort Janae L. Kirsch
collection DOAJ
description ABSTRACT Objective To explore pre–hematopoietic stem cell transplant (HSCT) demographic, disease, and psychological factors predictive of future transplant regret and to determine post‐HSCT variables associated with regret. Patients and Methods HSCT candidates participated in a prospective cohort study (June 2008–October 2013) examining health behaviors and HSCT outcomes, including completion of standardized surveys at pre‐HSCT (baseline) and 1‐year post‐HSCT. Cases were participants that endorsed regret at 1‐year post‐HSCT follow‐up, and controls were participants without regret at 1 year, matched on age, sex, and transplant type. For cases and controls, pre‐HSCT psychosocial evaluations were abstracted from the electronic health record and coded to determine the Psychosocial Assessment of Candidates for Transplantation score, psychosocial stressors, and mental health diagnoses. The association of selected factors with regret was estimated with odds ratios and 95% confidence intervals from conditional logistic regression models. Results At post‐HSCT, 49 participants of 638 endorsed transplant regret (8%) and formed the case group; 98 controls were matched from remaining participants. Cases and controls were well matched on age (56.6 vs. 57.2 years), sex (both groups 34.7% female), and transplant type (both groups 81.6% autologous). After controlling for the number of hospitalizations and active treatment status, conditional logistic regression revealed that patients who endorsed regret were 3.7 times (95% CI = 1.37–9.69, p = 0.008) more likely to not be in remission compared to controls at 1‐year post‐HSCT. Conclusion Matched case–control analyses revealed that no pre‐HSCT variables collected during the pre‐HSCT evaluation period were predictive of transplant regret, while poorer outcomes at 1‐year after transplant were associated with regret.
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spelling doaj-art-b4a17d652252402ba7d77d53f7ba3ea32025-08-20T02:56:09ZengWileyCancer Medicine2045-76342025-04-01147n/an/a10.1002/cam4.70828Predictors of Transplant Regret: A Case–Control Study Nested Within a Prospective Cohort of HSCT RecipientsJanae L. Kirsch0James R. Cerhan1William J. Hogan2Holly C. Edwards3Christi A. Patten4Tabetha Brockman5Christine Hughes6Angela Dispenzieri7Stephen M. Ansell8Dennis A. Gastineau9Shawna L. Ehlers10Department of Psychiatry and Psychology Mayo Clinic Rochester Minnesota USADivision of Epidemiology, Department of Health Sciences Research Mayo Clinic Rochester Minnesota USADivision of Hematology, Department of Medicine, College of Medicine Mayo Clinic Rochester Minnesota USADepartment of Psychiatry and Psychology Mayo Clinic Rochester Minnesota USADepartment of Psychiatry and Psychology Mayo Clinic Rochester Minnesota USADepartment of Psychiatry and Psychology Mayo Clinic Rochester Minnesota USADepartment of Psychiatry and Psychology Mayo Clinic Rochester Minnesota USADivision of Hematology, Department of Medicine, College of Medicine Mayo Clinic Rochester Minnesota USADivision of Hematology, Department of Medicine, College of Medicine Mayo Clinic Rochester Minnesota USADivision of Hematology, Department of Medicine, College of Medicine Mayo Clinic Rochester Minnesota USADepartment of Psychiatry and Psychology Mayo Clinic Rochester Minnesota USAABSTRACT Objective To explore pre–hematopoietic stem cell transplant (HSCT) demographic, disease, and psychological factors predictive of future transplant regret and to determine post‐HSCT variables associated with regret. Patients and Methods HSCT candidates participated in a prospective cohort study (June 2008–October 2013) examining health behaviors and HSCT outcomes, including completion of standardized surveys at pre‐HSCT (baseline) and 1‐year post‐HSCT. Cases were participants that endorsed regret at 1‐year post‐HSCT follow‐up, and controls were participants without regret at 1 year, matched on age, sex, and transplant type. For cases and controls, pre‐HSCT psychosocial evaluations were abstracted from the electronic health record and coded to determine the Psychosocial Assessment of Candidates for Transplantation score, psychosocial stressors, and mental health diagnoses. The association of selected factors with regret was estimated with odds ratios and 95% confidence intervals from conditional logistic regression models. Results At post‐HSCT, 49 participants of 638 endorsed transplant regret (8%) and formed the case group; 98 controls were matched from remaining participants. Cases and controls were well matched on age (56.6 vs. 57.2 years), sex (both groups 34.7% female), and transplant type (both groups 81.6% autologous). After controlling for the number of hospitalizations and active treatment status, conditional logistic regression revealed that patients who endorsed regret were 3.7 times (95% CI = 1.37–9.69, p = 0.008) more likely to not be in remission compared to controls at 1‐year post‐HSCT. Conclusion Matched case–control analyses revealed that no pre‐HSCT variables collected during the pre‐HSCT evaluation period were predictive of transplant regret, while poorer outcomes at 1‐year after transplant were associated with regret.https://doi.org/10.1002/cam4.70828health statushematopoietic stem cell transplantillness perceptiononcologytransplant regret
spellingShingle Janae L. Kirsch
James R. Cerhan
William J. Hogan
Holly C. Edwards
Christi A. Patten
Tabetha Brockman
Christine Hughes
Angela Dispenzieri
Stephen M. Ansell
Dennis A. Gastineau
Shawna L. Ehlers
Predictors of Transplant Regret: A Case–Control Study Nested Within a Prospective Cohort of HSCT Recipients
Cancer Medicine
health status
hematopoietic stem cell transplant
illness perception
oncology
transplant regret
title Predictors of Transplant Regret: A Case–Control Study Nested Within a Prospective Cohort of HSCT Recipients
title_full Predictors of Transplant Regret: A Case–Control Study Nested Within a Prospective Cohort of HSCT Recipients
title_fullStr Predictors of Transplant Regret: A Case–Control Study Nested Within a Prospective Cohort of HSCT Recipients
title_full_unstemmed Predictors of Transplant Regret: A Case–Control Study Nested Within a Prospective Cohort of HSCT Recipients
title_short Predictors of Transplant Regret: A Case–Control Study Nested Within a Prospective Cohort of HSCT Recipients
title_sort predictors of transplant regret a case control study nested within a prospective cohort of hsct recipients
topic health status
hematopoietic stem cell transplant
illness perception
oncology
transplant regret
url https://doi.org/10.1002/cam4.70828
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