Researchers from the Center for International Blood and Marrow Transplant Research (CIBMTR) identified relationships between patient-reported outcomes (PROs) and overall survival (OS) in a new study, although without appearing to influence the performance of a calculator to predict OS. The research team of Bronwen E. Shaw, MD, PhD, of CIBMTR in Milwaukee, Wisconsin, and colleagues, presented the study’s findings in a poster at the 2022 ASCO Annual Meeting.
The CIBMTR provides a calculator for 1-year OS to transplant teams in order to provide an estimate of a patient’s OS risk with allogeneic hematopoietic stem cell transplantation (HCT), Dr Shaw and colleagues explained in their poster. The calculator has historically incorporated factors such as pre-HCT clinical and demographic features and Karnofsky performance score into its algorithm, but PROs have not previously been included. Noting the relevance that PRO scores prior to HCT has demonstrated in other studies related to OS, the researchers undertook this analysis to determine the appropriateness of including PRO measures into the CIBMTR’s OS calculator.
The study was based on an analysis of existing data from the CIBMTR database and from PROs that were collected in 5 prospective, randomized clinical trials associated with the Blood and Marrow Transplant Clinical Trials Network. PRO measurements were based on the SF36 physical component score (PCS) the SF36 mental component score (MCS), and the FACT-BMT Trial outcome index (TOI).
Additionally, a single question was tested regarding whether a patient considered his/her health to be excellent/very good/good or fair/poor. HCT was performed in the included patients between 2004 and 2014, and OS was evaluated as an outcome during the first year following HCT.
A total of 1033 patients were included from 67 centers in this analysis. Not all patients completed each PRO measure, with 33% completing the SF36 only, 33% completed the FACT-BMT measure only, and 34% completing both.
Of the PRO measures, only PCS scores were significantly predictive of mortality (hazard ratio [HR], 0.88; 95% CI, 0.81-0.96; P =.0021). Also, the single question regarding patients’ perceptions of their general health was predictive of mortality (HR, 0.52; 95% CI, 0.35-0.74; P =.0004). Overall, the researchers did not find PRO scores to contribute significant changes to the calculator’s ability to predict OS.
While PROs did not significantly affect the calculator’s predictive capacity, the researchers found a significant and independent association between PROs prior to HCT and OS outcomes. Among PRO measures, the SF36 PCS showed a significant relationship with OS, while the SF36 MCS and FACT-TOI measures were not significant predictors of OS outcomes.
The single question on patient perception of general health also appeared predictive of OS. “We showed, for the first time in this treatment context, that a single general health question was as accurate as the SF36 physical component summary score for predicting survival, suggesting that PRO data collected for this purpose could be greatly simplified,” study coauthor Kathryn Flynn noted in a video accompanying the research team’s poster.
Disclosures: Some authors have declared affiliations with or received grant support from the pharmaceutical industry. Please refer to the original study for a full list of disclosures.
Shaw BE, Flynn KE, Cusatis R, et al. Incorporating patient-reported outcome data into a hematopoietic cell transplant survival calculator. Presented at ASCO 2022; June 3-7, 2022. Abstract 7045.