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Predictors of return to work after autologous stem cell transplantation in patients with multiple myeloma

Bone Marrow Transplantation volume 56, pages 2904–2910 (2021)Cite this article

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Abstract

Return to work (RTW) is a marker of functional recovery in cancer patients, with quality of life, financial and social implications. We investigated frequency and factors associated with RTW in a cohort of patients younger than 66 years, with newly diagnosed multiple myeloma (MM), uniformly treated with a bortezomib-based induction followed by autologous stem cell transplantation (ASCT). Socio-economic and working status data were collected by a self-administered questionnaire. One hundred and eighty-six patients entered the study. Of whom, 145 (78%) where employed at diagnosis, which was more frequent in younger (median 55 vs. 60 years, p < 0.001), men (59.3% vs. 34.2%, p = 0.004), and with college studies (44.8% vs. 24.4%, p = 0.008). Forty-three (30%) of the 145 patients who had a job at diagnosis, RTW after ASCT in a median of 5 (range 1–27) months. Factors independently associated with RTW were having three or more children (HR 2.87, 95% CI 1.33–6.18), college studies (HR 2.78, 95% CI 1.21–6.41), and a family income >40 × 103€/year (HR 2.31, 95% CI 1.12–4.78). In conclusion, the frequency of RTW herein reported in MM patients seems lower than reported in other malignancies. The risk factors observed may guide the design RTW programs.

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Fig. 1: Cumulative incidence of RTW.
Fig. 2
Fig. 3

References

  1. Kennedy F, Haslam C, Munir F, Pryce J. Returning to work following cancer: a qualitative exploratory study into the experience of returning to work following cancer. Eur J Cancer Care. 2007;16:17–25.

    Article  CAS  Google Scholar 

  2. Désiron HA, Crutzen R, Godderis L, Van Hoof E, de Rijk A. Bridging health care and the workplace: formulation of a return-to-work intervention for breast cancer patients using an intervention mapping approach. J Occup Rehabil. 2016;26:350–65.

    Article  Google Scholar 

  3. Bradley CJ, Brown KL, Haan M, Glasgow RE, Newman LS, Rabin B, et al. Cancer survivorship and employment: intersection of oral agents, changing workforce dynamics, and employers’ perspectives. J Natl Cancer Inst. 2018;110:1292–99.

    Article  Google Scholar 

  4. de Boer AG, Torp S, Popa A, Horsboel T, Zadnik V, Rottenberg Y, et al. Long-term work retention after treatment for cancer: a systematic review and meta-analysis. J Cancer Surviv. 2020;14:135–50.

    Article  Google Scholar 

  5. de Boer AG, Taskila T, Ojajärvi A, van Dijk FJ, Verbeek JH. Cancer survivors and unemployment: a meta-analysis and meta-regression. JAMA. 2009;301:753–62.

    Article  Google Scholar 

  6. Taskila T, de Boer AG, van Dijk FJ, Verbeek JH. Fatigue and its correlates in cancer patients who had returned to work-a cohort study. Psychooncology. 2011;20:1236–41.

    Article  CAS  Google Scholar 

  7. Kline RM, Arora NK, Bradley CJ, Brauer ER, Graves DL, Lunsford NB, et al. Long-term survivorship care after cancer treatment—summary of a 2017 National Cancer Policy Forum Workshop. J Natl Cancer Inst. 2018;110:1300–10.

    Article  Google Scholar 

  8. Sharp L, O’Leary E, Kinnear H, Gavin A, Drummond FJ. Cancer-related symptoms predict psychological wellbeing among prostate cancer survivors: results from the PiCTure study. Psychooncology. 2016;25:282–91.

    Article  Google Scholar 

  9. National Cancer Institute. SEER cancer stat facts: myeloma. Bethesda, MD: National Cancer Institute. https://seer.cancer.gov/statfacts/html/mulmy.htm. Accessed Dec 2020.

  10. Alexander DD, Mink PJ, Adami HO, Cole P, Mandel JS, Oken MM, et al. Multiple myeloma: a review of the epidemiologic literature. Int J Cancer. 2012;20:40–61.

    Google Scholar 

  11. Kyle RA, Gertz MA, Witzig TE, Lust JA, Lacy MQ, Dispenzieri A, et al. Review of 1027 patients with newly diagnosed multiple myeloma. Mayo Clin Proc. 2003;78:21–33.

    Article  Google Scholar 

  12. Rosiñol L, Oriol A, Teruel AI, Hernández D, López-Jiménez J, de la Rubia J, et al. Superiority of bortezomib, thalidomide, and dexamethasone (VTD) as induction pretransplantation therapy in multiple myeloma: a randomized phase 3 PETHEMA/GEM study. Blood. 2012;120:1589–96.

    Article  Google Scholar 

  13. Attal M, Lauwers-Cances V, Hulin C, Leleu X, Caillot D, Escoffre M, et al. Lenalidomide, bortezomib, and dexamethasone with transplantation for myeloma. N Engl J Med. 2017;376:1311–20.

    Article  CAS  Google Scholar 

  14. Kristinsson S, Anderson W, Landgren O. Improved long-term survival in multiple myeloma up to the age of 80 years. Leukemia. 2014;28:1346–8.

    Article  CAS  Google Scholar 

  15. Blimark CH, Turesson I, Genell A, Ahlbert L, Björkstrand, Carlson K, et al. Outcome and survival of myeloma patients diagnosed 2008–15. Real-world data on 4904 patients from the Swedish Myeloma Registry. Haematologica. 2018;103:506–13.

    Article  CAS  Google Scholar 

  16. Langseth ØO, Myklebust TÅ, Johannesen TB, Hjertner Ø, Waage A. Incidence and survival of multiple myeloma: a population-based study of 10 524 patients diagnosed 1982–2017. Br J Haematol. 2020;191:418–25.

    Article  Google Scholar 

  17. Costa LJ, Brill IK, Omel J, Godby K, Kumar SK, Brown EE. Recent trends in multiple myeloma incidence and survival by age, race, and ethnicity in the United States. Blood Adv. 2017;1:282–7.

    Article  Google Scholar 

  18. Cancer Research UK. https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/myeloma. Accessed Dec 2020.

  19. Ravi P, Kumar SK, Cerhan JR, Maurer MJ, Dingli D, Ansell SM, et al. Defining cure in multiple myeloma: a comparative study of outcomes of young individuals with myeloma and curable hematologic malignancies. Blood Cancer J. 2018;8:26.

    Article  Google Scholar 

  20. Horsboel TA, Nielsen CV, Nielsen B, Jensen C, Andersen NT, de Thurah A. Type of hematological malignancy is crucial for the return-to-work prognosis: a register-based cohort study. J Cancer Surviv. 2013;7:614–23.

    Article  Google Scholar 

  21. Syrjala KL, Langer SL, Abrams JR, Storer B, Sanders JE, Flowers MED, et al. Recovery and long-term function after hematopoietic cell transplantation for leukemia or lymphoma. JAMA. 2004;291:2335–43.

    Article  CAS  Google Scholar 

  22. Kirchhoff AC, Leisenring W, Syrjala KL. Prospective predictors of return to work in the 5 years after hematopoietic cell transplantation. J Cancer Surviv. 2010;4:33–44.

    Article  Google Scholar 

  23. Hensel M, Egerer G, Schneeweiss A, Goldschmidt H, Ho AD. Quality of life and rehabilitation in social and professional life after autologous stem cell transplantation. Ann Oncol. 2002;13:209–17.

    Article  CAS  Google Scholar 

  24. Gruber U, Fegg M, Buchmann M, Kolb HJ, Hiddemann W. The longterm psychosocial effects of haematopoetic stem cell transplantation. Eur J Cancer Care. 2003;12:249–56.

    CAS  Google Scholar 

  25. Bieri S, Roosnek E, Helg C, Verholen F, Robert D, Chapuis B, et al. Quality of life and social integration after allogeneic hematopoietic SCT. Bone Marrow Transplant. 2008;42:819–27.

    Article  CAS  Google Scholar 

  26. Tichelli A, Gerull S, Holbro A, Buser A, Nair G, Medinger M, et al. Inability to work and need for a disability pension among long-term survivors of hematopoietic stem cell transplantation. Bone Marrow Transplant. 2017;52:1436–42.

    Article  CAS  Google Scholar 

  27. Arboe B, Olsen MH, Goerloev JS, Duun-Henriksen AK, Johansen C, Dalton SO, et al. Return to work for patients with diffuse large B-cell lymphoma and transformed indolent lymphoma undergoing autologous stem cell transplantation. Clin Epidemiol. 2017;9:321–9.

    Article  Google Scholar 

  28. Kiserud CE, Fagerli UM, Smeland KB, Fluge O, Bersvendsen H, Kvaloy S, et al. Pattern of employment and associated factors in long-term lymphoma survivors 10 years after high-dose chemotherapy with autologous stem cell transplantation. Acta Oncol. 2016;55:547–53.

    Article  CAS  Google Scholar 

  29. Jackson G, Galinsky J, Alderson DEC, D’Souza VK, Buchanan V, Dhanasiri S, et al. Productivity losses in patients with newly diagnosed multiple myeloma following stem cell transplantation and the impact of maintenance therapy. Eur J Haematol. 2019;103:393–401.

    Article  Google Scholar 

  30. Jagsi R, Hawley ST, Abrahamse P, Li Y, Janz NK, Griggs JJ, et al. Impact of adjuvant chemotherapy on long-term employment of survivors of early-stage breast cancer. Cancer. 2014;120:1854–62.

    Article  Google Scholar 

  31. Marino P, Teyssier LS, Malavolti L, Le Corroller-Soriano AG. Sex differences in the return-to-work process of cancer survivors 2 years after diagnosis: results from a large French population-based sample. J Clin Oncol. 2013;31:1277–84.

    Article  Google Scholar 

  32. Hulin C, Hansen T, Heron L, Pughe R, Streetly M, Plate A, et al. Living with the burden of relapse in multiple myeloma from the patient and physician perspective. Leuk Res. 2017;59:75–84.

    Article  Google Scholar 

  33. Drolet M, Maunsell E, Brisson J, Brisson C, Mâsse B, Deschênes L. Not working 3 years after breast cancer: predictors in a population-based study. J Clin Oncol. 2005;23:8305–12.

    Article  Google Scholar 

  34. Landeiro LCG, Gagliato DM, Fêde AB, Fraile NM, Lopez RM, da Fonseca LG, et al. Return to work after breast cancer diagnosis: an observational prospective study in Brazil. Cancer. 2018;124:4700–10.

    Article  Google Scholar 

  35. Vartanian JG, Carvalho AL, Toyota J, Kowalski IS, Kowalski LP. Socioeconomic effects of and risk factors for disability in long-term survivors of head and neck cancer. Arch Otolaryngol Head Neck Surg. 2006;132:32–5.

    Article  Google Scholar 

  36. https://www.ine.es/jaxiT3/Datos.htm. Accessed Apr 2021.

Download references

Acknowledgements

This study was supported in part by grants 2017 SGR 1395 from the Catalan Government and RD16/0011/0028 Instituto de Salud Carlos III, Ministerio de Ciencia e Innovación, Spain.

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Authors and Affiliations

  1. Hematology Department, Hospital de la Santa Creu i Sant Pau, Institut d’Investigació Biomèdica Sant Pau, Josep Carreras Leukemia Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain

    Miquel Granell, Anna Barata, Jordi López-Pardo, Rodrigo Martino & Jorge Sierra

  2. Institut Català d’Oncologia, Hospital Universitari Germans Trias i Pujol, Josep Carreras Leukemia Research Institute, Badalona, Spain

    Alicia Senín & Albert Oriol

  3. Health Outcomes and Behavior Department, Moffitt Cancer Center, Tampa, FL, US

    Anna Barata

  4. Amyloidosis and Myeloma Unit, Department of Hematology, Hospital Clínic of Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain

    Maria-Teresa Cibeira, Carlos Fernández de Larrea & Laura Rosiñol

  5. Hematology Department, Hospital Universitari Vall d’Hebron, Barcelona, Spain

    Mercedes Gironella

  6. Hematology Department, Hospital Sant Joan de Déu Manresa, Barcelona, Spain

    Cristina Motlló

  7. Hematology Department, Hospital Universitari Arnau de Vilanova, Lleida, Spain

    Antoni Garcia-Guiñón

  8. Hematology Department, Hospital del Mar-IMIM, Universitat Autònoma de Barcelona, Barcelona, Spain

    Randa Ben-Azaiz & Eugènia Abella

  9. Hematology Department, Hospital Universitari Parc Taulí Sabadell, Barcelona, Spain

    Alfons Soler

  10. Hematology Department, Hospital Universitari Mútua de Terrassa, Barcelona, Spain

    Marta Canet & Josep Ma Martí

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  1. Miquel Granell
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Consortia

for the Group for the Study of Myeloma and Amyloidosis of Catalonia (GEMMAC)

  • Miquel Granell
  • , Alicia Senín
  • , Maria-Teresa Cibeira
  • , Mercedes Gironella
  • , Jordi López-Pardo
  • , Cristina Motlló
  • , Antoni Garcia-Guiñón
  • , Eugènia Abella
  • , Alfons Soler
  • , Josep Ma Martí
  • , Carlos Fernández de Larrea
  • , Albert Oriol
  •  & Laura Rosiñol

Contributions

MGr and AB designed the study. MGr, AS, M-TC, MGi, JL-P, CM, AG-G, EA, RB-A, J-MM, JS, CFL, AO, and LR identified candidates to the study, obtained informed consent, and collected data. MGr and RM analyzed and interpreted data and wrote the manuscript. All the authors reviewed the manuscript and approved the final version.

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Correspondence to Miquel Granell or Anna Barata.

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Granell, M., Senín, A., Barata, A. et al. Predictors of return to work after autologous stem cell transplantation in patients with multiple myeloma. Bone Marrow Transplant 56, 2904–2910 (2021). https://doi.org/10.1038/s41409-021-01429-0

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  • DOI: https://doi.org/10.1038/s41409-021-01429-0

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