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Psychosocial Assessment of Candidates for Transplant (PACT) as a tool for psychological and social evaluation of allogeneic hematopoietic cell transplantation recipients

Bone Marrow Transplantation volume 54, pages 1443–1452 (2019)Cite this article

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Abstract

Psychosocial Assessment of Candidates for Transplant (PACT) is a tool originally developed to address psychosocial risks in solid organ transplant recipients and has the potential for application to hematopoietic cell transplantation (HCT) recipients. In a retrospective cohort study, we reviewed 404 adult allogeneic HCT cases from 2003 to 2014 to identify predictors of adverse psychosocial status as determined by PACT. Final PACT rating was poor/borderline (score 0–1) in 5%, acceptable (score 2) in 22%, good (score 3) in 44%, and excellent (score 4) in 29% recipients. In multivariable regression, higher PACT score was associated with White race (odds ratio [OR] 2.95, P < 0.001), having a related donor (OR 1.61, P = 0.015), and a higher quality of life score (OR 1.22/ 10-point increase in FACT-BMT total score, P < 0.001). PACT score correlated with all quality of life subscales. The final PACT score was associated with non-relapse mortality (HR 0.82/ 1-point increase, p = 0.03) in multivariable analysis that considered patient and disease factors, but not in models that also included transplant-related factors and performance status. PACT score was not associated with overall survival. PACT can be considered as part of a comprehensive psychosocial assessment for identifying patients who may require additional resources around allogeneic HCT.

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Funding

NM is partially supported by a grant from the National Cancer Institute (R01-CA215134).

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Authors and Affiliations

  1. Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA

    Sanghee Hong & Stephanie J. Lee

  2. Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, USA

    Lisa Rybicki

  3. Blood & Marrow Transplant Program, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA

    Donna Corrigan, Jane Dabney, Betty K. Hamilton, Matt Kalaycio, Christine Lawrence, Linda McLellan, Ronald Sobecks & Navneet S. Majhail

  4. Department of Hematology and Oncology, Cleveland Clinic, Cleveland, OH, USA

    Betty K. Hamilton, Matt Kalaycio, Ronald Sobecks & Navneet S. Majhail

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  1. Sanghee Hong
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  2. Lisa Rybicki
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  3. Donna Corrigan
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  7. Christine Lawrence
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Correspondence to Sanghee Hong.

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Hong, S., Rybicki, L., Corrigan, D. et al. Psychosocial Assessment of Candidates for Transplant (PACT) as a tool for psychological and social evaluation of allogeneic hematopoietic cell transplantation recipients. Bone Marrow Transplant 54, 1443–1452 (2019). https://doi.org/10.1038/s41409-019-0455-y

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