In a recent study involving recipients of hematopoietic cell transplantation (HCT), researchers identified an association between socioenvironmental experiences and a particular immunoregulatory pattern. The study’s findings were presented at the 2022 ASH Annual Meeting by Mallory Taylor, MD, of the Seattle Children’s Research Institute in Seattle, Washington, and colleagues.

The immunoregulatory pattern examined in this study is the conserved transcriptional response to adversity (CTRA), which is a genomic biomarker linked to higher expression of pro-inflammatory genes and lower expression of antiviral genes. This pattern has been associated with both psychosocial adversity and outcomes for recipients of HCT. Based on these potential relationships, the researchers aimed to identify whether patients’ CTRA profiles prior to allogeneic HCT showed associations with psychosocial patient-reported outcomes (PROs) in this study on social determinants of health.

This cross-sectional study evaluated data from patients receiving allogeneic HCT who had participated in an earlier Center for International Blood and Marrow Transplant Research study regarding PROs. PROs that were analyzed in this study involved results from the 36-Item Short Form Health Survey (SF-36) and the Functional Assessment of Cancer Therapy–Bone Marrow Transplant (FACT-BMT). The researchers also analyzed CTRA data through RNA sequencing of blood samples obtained from patients prior to transplant. They used mixed-effects linear regression models to determine if there were associations between CTRA patterns and PRO results, with these models controlled for various demographic and clinical factors.

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There were 121 patients evaluated in this study, with a median age of 54 years (range, 18-74). Race was identified as White in 91% of participants and 95% of participants had been diagnosed with a hematologic malignancy.

The researchers identified several significant associations between CTRA-related gene expression and various PROs in this study. Lower CTRA-related gene expression showed a statistically significant association with higher total scores on the FACT-BMT. Lower CTRA-related gene expression was also linked to higher scores for FACT-BMT social well-being, FACT-general score, FACT-BMT physical well-being, and the FACT-BMT-specific subdomain. There were not statistically significant relationships between CTRA-related gene expression and FACT-BMT emotional or functional well-being and SF-36 mental or physical component scores.

For patients in the highest category of social well-being, compared with the lowest category of social well-being, there was an approximately 15% difference in CTRA-related gene expression. Transcriptional patterns appeared to be most strongly associated with social well-being, compared with other FACT domains.

The researchers concluded that CTRA immunoregulatory patterns in this study population were associated with patient-reported social determinants of health, particularly with regard to social well-being. They recommended further research be directed at understanding these patterns and possible interventions.

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.


Taylor M, Cole SW, Strom J, et al. Association between patient-reported social determinant of health outcomes and a social genomics profile in allogeneic hematopoietic cell transplantation: a Center for International Blood and Marrow Transplant Research (CIBMTR) analysis. Presented at ASH 2022. December 10-13, 2022. Abstract 375.