Document Type : Research articles

Authors

1 Dr.A.Y. Ankara Oncology Training and Research Hospital

2 Dr.A.Y.Ankara Oncology Research and Education Hospital

Abstract

Background: The effectiveness of autologous stem cell transplantation (ASCT) in patients with relapsed/refractory lymphoma is accepted by all authors. After ASCT, the 5-year overall survival rates can reach up to 80%. However, returning to work after ASCT and the employment status of these patients are unknown.
Objectives: This study aimed to examine the rate of not returning to work in the post-treatment period and the factors that may affect the employment status of patients who underwent ASCT with the diagnosis of relapsed/refractory lymphoma.
Methods: This cross-sectional study was conducted from January to June 2020. It was performed on patients within the age ranges of 18-65 who had undergone ASCT with the diagnosis of relapsed or refractory lymphoma and were in remission without recurrence one year after ASCT.
Results: In total, 80 (74.8%) out of 107 patients included in the study were male, and the median age was 49.0 (21-63). Majority of participants were primary school graduates (n=66, 61.7%) and married (n=90, 84.1%). Before ASCT, 30 (28.0%) patients worked in the private sector and 17 (15.9%) of them were self-employed. The median follow-up time was 34.8 months (12.4 - 124.7 months). During this follow-up period, 35 (57.3%) out of 61 patients did not return to work. Most of these patients had retired (n=29, 47.5%). It was observed that having a higher education level (OR: 0.32 [0.14-1.22] 95% CI, p:0.041) and being a public employee (OR: 0.30 (0.12-0.97) 95% CI, p:0.033) are independent factors that reduce the risk of not returning to work.
Conclusion: It was found that more than half of the patients did not return to work. The low level of education and employment in non-public sectors posed the risk of not returning to work. It may be possible for patients to return to work with well-planned options, such as part-time shifts.

Keywords

  1. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2020. CA Cancer J Clin. 2020;70(1):7-30. doi: 10.3322/caac.21590. [PubMed: 31912902].
  2. Zahid U, Akbar F, Amaraneni A, Husnain M, Chan O, Riaz IB, et al. A review of autologous stem cell transplantation in lymphoma. Curr Hematol Malig Rep. 2017;12(3):217-26. doi: 10.1007/s11899-017-0382-1. [PubMed: 28478586].
  3. Schmitz N, Pfistner B, Sextro M, Sieber M, Carella AM, Haenel M, et al. Aggressive conventional chemotherapy compared with high-dose chemotherapy with autologous haemopoietic stem-cell transplantation for relapsed chemosensitive Hodgkin’s disease: a randomised trial. Lancet. 2002; 359(9323):2065-71. doi: 10.1016/S0140-6736(02)08938-9. [PubMed: 12086759].
  4. Philip T, Guglielmi C, Hagenbeek A, Somers R, Van der Lelie H, Bron D, et al. Autologous bone marrow transplantation as compared with salvage chemotherapy in relapses of chemotherapy-sensitive non-Hodgkin’s lymphoma. N Engl J Med. 1995;333(23):1540-5. doi: 10.1056/NEJM199512073332305. [PubMed: 7477169].
  5. Stiff PJ, Unger JM, Cook JR, Constine LS, Couban S, Stewart DA, et al. Autologous transplantation as consolidation for aggressive non-Hodgkin’s lymphoma. N Engl J Med. 2013; 369(18):1681-90. doi: 10.1056/NEJMoa1301077. [PubMed: 24171516].
  6. Falzetti F, Di Ianni M, Ballanti S, Iodice G, Reale A, Minelli O, et al. High-dose thiotepa, etoposide and carboplatin as conditioning regimen for autologous stem cell transplantation in patients with high-risk non-Hodgkin lymphoma. Clin Exp Med. 2012;12(3):165-71. doi: 10.1007/s10238-011-0157-2. [PubMed: 21928053].
  7. Naughton MJ, Weaver KE. Physical and mental health among cancer survivors: considerations for long-term care and quality of life. N C Med J. 2014;75(4):283-6. doi: 10.18043/ncm.75.4.283. [PubMed: 25046097].
  8. Yıldız F, Alaguney ME. Is early-stage breast cancer a risk for marital-dissolution? Med Sci Discov. 2020;7(7):566-9. doi: 10.36472/msd.v7i7.400.
  9. Schmidt ME, Scherer S, Wiskemann J, Steindorf K. Return to work after breast cancer: The role of treatment-related side effects and potential impact on quality of life. Eur J Cancer Care (Engl). 2019;28(4):e13051. doi: 10.1111/ecc.13051. [PubMed: 31033073].
  10. Johnsson A, Fornander T, Rutqvist LE, Olsson M. Work status and life changes in the first year after breast cancer diagnosis. Work. 2010;38(4):337-46. doi: 10.3233/WOR-2011-1137. [PubMed: 21508523]
  11. Yıldız F, Alaguney ME. Factors associated with the employment status of breast cancer survivors: a single center cross-sectional study. Int J Community Med Public Health. 2020;7(8):2874-9. doi: 10.18203/2394-6040.ijcmph20203357.
  12. Kiserud CE, Fagerli UM, Smeland KB, Fluge Ø, Bersvendsen H, Kvaløy 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(5):547-53. doi: 10.3109/0284186X.2015. 1125015. [PubMed: 27123741].
  13. Majhail NS. Long-term complications after hematopoietic cell transplantation. Hematol Oncol Stem Cell Ther. 2017; 10(4):220-7. doi: 10.1016/j.hemonc.2017.05.009. [PubMed: 28641097].
  14. Pidala J, Anasetti C, Jim H. Health-related quality of life following haematopoietic cell transplantation: patient education, evaluation and intervention. BR J Haematol. 2010;148(3):373-85. doi: 10.1111/j.1365-2141.2009.07992.x. [PubMed: 19919651].
  15. Pidala J, Anasetti C, Jim H. Quality of life after allogeneic hematopoietic cell transplantation. Blood. 2009;114(1):7-19. doi: 10.1182/blood-2008-10-182592. [PubMed: 19336756].
  16. Syrjala KL, Langer SL, Abrams JR, Storer B, Sanders JE, Flowers ME, et al. Recovery and long-term function after hematopoietic cell transplantation for leukemia or lymphoma. JAMA. 2004; 291(19):2335-43. doi: 10.1001/jama.291.19.2335. [PubMed: 15150205].
  17. 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 7. Ann Oncol. 2002;13(2):209-17. doi: 10.1093/annonc/mdf031.
  18. 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 4. J Cancer Surviv. 2013;7(4):614-23. doi: 10.1007/s11764-013-0300-z. [PubMed: 23949119].
  19. Abrahamsen AF, Loge JH, Hannisdal E, Holte H, Kvaløy S. Socio-medical situation for long-term survivors of Hodgkin's disease: a survey of 459 patients treated at one institution. Eur J Cancer. 1998;34(12):1865-70. doi: 10.1016/s0959-8049(98)00269-x. [PubMed: 10023307].
  20. Winterling J, Johansson E, Wennman-Larsen A, Petersson LM, Ljungman P, Alexanderson K. Occupational status among adult survivors following allo-SCT. Bone Marrow Transplant. 2014;49(6):836-42. doi: 10.1038/bmt.2014.26. [PubMed: 24614841].
  21. 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(1):33-44. doi: 10.1007/s11764-009-0105-2. [PubMed: 19936935].
  22. Mosher CE, Redd WH, Rini CM, Burkhalter JE, Du Hamel KN. Physical, psychological, and social sequelae following hematopoietic stem cell transplantation: a review of the literature. Psychooncology. 2009;18(2):113-27. doi: 10.1002/ pon.1399. [PubMed: 18677717].