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Prevalence of self-reported sleep dysfunction before allogeneic hematopoietic cell transplantation

Bone Marrow Transplantation volume 53, pages 1079–1082 (2018)Cite this article

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To the Editor,

Allogeneic hematopoietic cell transplantation (alloHCT) is an increasingly utilized high-risk therapy used to treat various malignant and nonmalignant diseases [1]. The numbers of alloHCT performed each year continue to increase for all age groups, particularly those aged 60 and older [1], and it remains a physically and psychologically arduous treatment approach [2, 3]. Nearly 75–80% of hospitalized HCT patients experience sleep disruption in the early post-transplant setting [4, 5]; this can exacerbate impaired quality of life, depression, and fatigue in HCT recipients [6]. Sleep is a restorative biologic process essential for maintaining health [7]. There is epidemiologic evidence that sleep disturbance independently contributes to inflammation and that improving sleep quality in older adults with insomnia can reduce biomarkers of multisystem biological risk, including C-reactive protein, hemoglobin A1C, insulin, lipoproteins, and triglycerides among others, in a randomized clinical trial setting [8, 9]. Sleep dysfunction may adversely impact alloHCT outcomes through increased pro-inflammatory pathways as shown in HCT and other populations and may lead to adverse post-alloHCT outcomes [5, 10]. Based on this intriguing background, we hypothesized that patient-reported sleep disturbance before alloHCT would correlate with early post-alloHCT outcomes. We used the Center for International Blood and Marrow Transplant Research (CIBMTR) database to conduct this research.

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Acknowledgements

The CIBMTR is supported by the National Institutes of Health (NIH) grants Nos. U24CA076518 and HL069294, Health Resources and Service Administration (HRSA) contract No. HHSH250201200016C. This publication is funded in part by the Research and Education Program Fund, a component of the Advancing a Healthier Wisconsin endowment at the Medical College of Wisconsin and by KL2TR001438 from the Clinical and Translational Science Award program of the National Center for Advancing Translational Sciences (AD). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIH.

Author contributions

A.D., H.M., and B.E.S. designed the research, analyzed the data, and wrote the manuscript; J.K., R.B., S.J.L., K.E.F., and J.D.R. assisted in data collection, interpretation, and manuscript preparation; all authors approved the final draft of the manuscript. This work was presented as a poster at the 59th Annual Meeting of the American Society of Hematology.

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Authors and Affiliations

  1. Department of Medicine, Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI, USA

    Anita D’Souza, Heather Millard, Ruta Brazauskas, Kathryn E Flynn, J Douglas Rizzo & Bronwen E Shaw

  2. Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI, USA

    Jennifer Knight

  3. Fred Hutchinson Cancer Research Center, Seattle, WA, USA

    Stephanie J Lee

Authors
  1. Anita D’Souza
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  2. Heather Millard
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  3. Jennifer Knight
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  4. Ruta Brazauskas
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  5. Stephanie J Lee
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  6. Kathryn E Flynn
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  7. J Douglas Rizzo
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  8. Bronwen E Shaw
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Correspondence to Anita D’Souza.

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D’Souza, A., Millard, H., Knight, J. et al. Prevalence of self-reported sleep dysfunction before allogeneic hematopoietic cell transplantation. Bone Marrow Transplant 53, 1079–1082 (2018). https://doi.org/10.1038/s41409-018-0150-4

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