Pre-Transplant Marital Status and Hematopoietic Cell Transplantation Outcomes

Area of Science:

• Hematopoietic Cell Transplantation (HCT)
• Immunology
• Oncology

Background:

• Conflicting evidence exists regarding the influence of pre-transplant marital status on outcomes following HCT.
• Understanding psychosocial factors like marital status is crucial for optimizing HCT patient care.

Purpose of the Study:

• To investigate the association between marital status before HCT and patient outcomes.
• To analyze the impact of marital status on overall survival, acute graft-versus-host disease (GVHD), and chronic GVHD.

Main Methods:

• Retrospective analysis of 10,226 allogeneic and 5714 autologous HCT cases from the Center for International Blood and Marrow Transplant Research registry (2008-2015).
• Patients were aged 40 years or older.
• Multivariable analysis was used to assess the relationship between marital status (married/partnered, single, separated/divorced, widowed) and transplant outcomes.

Main Results:

• No significant association was found between marital status and overall survival in either allogeneic or autologous HCT.
• Marital status was significantly associated with the risk of grades 2-4 acute GVHD (p < 0.001) and chronic GVHD (p = 0.04).
• Separated patients had an increased risk of acute GVHD, while single patients had a reduced risk. Widowed patients had a lower risk of chronic GVHD compared to married patients.

Conclusions:

• While marital status does not affect overall survival post-HCT, it is linked to varying risks of acute and chronic GVHD.
• Future research should incorporate validated measures of social support, caregiver commitment, and quality of life to further elucidate these associations.