Developing a Risk Prediction Model for Long-Term Physical and Psychological Functioning after Hematopoietic Cell...

Area of Science:

• Hematopoietic cell transplantation (HCT) research
• Clinical outcomes research
• Health services research

Background:

• Hematopoietic cell transplantation (HCT) survivors may experience long-term physical and psychological impairments.
• Accurate prediction of these impairments is needed to optimize supportive care referrals.

Purpose of the Study:

• To develop and validate risk prediction models for physical and psychological functioning in long-term HCT survivors.
• To identify key predictors of post-HCT functional outcomes.

Main Methods:

• Secondary analysis of data from a randomized controlled trial (NCT00799461) including 489 HCT survivors (3-10 years post-transplant).
• Backward logistic regression was used to develop risk prediction models.
• Internal validation was performed using bootstrapping, and risk scores were derived.

Main Results:

• Younger age, higher BMI, non-full-time work, comorbidities, autologous HCT, and chronic graft-versus-host disease predicted impaired physical functioning.
• Female gender, younger age, higher BMI, not living with a partner, autologous HCT, and chronic graft-versus-host disease predicted impaired psychological functioning.
• Models demonstrated moderate diagnostic accuracy (AUC for physical functioning: 0.74; AUC for psychological functioning: 0.69).

Conclusions:

• Readily accessible, pre-transplantation predictors can forecast long-term physical and psychological functioning in HCT survivors.
• Risk prediction models can inform clinical decisions regarding supportive care.
• Model accuracy may be enhanced by incorporating pre-transplantation patient-reported functioning and comorbidities.