Table 4

Multivariate analysis of sociodemographic and clinical factors in relation to poor psychological outcomes among HCT survivors

AnxietyDepressionSomatizationGlobal distress
OR (95% CI)POR (95% CI)POR (95% CI)POR (95% CI)P
Sex
    Female1.001.001.001.00
    Male1.02 (0.56-1.86).951.80 (1.14-2.85).010.89 (0.60-1.31).551.09 (0.68-1.76).71
Race/ethnicity
    Non-Hispanic white1.001.001.001.00
    Others1.94 (0.98-3.87).061.28 (0.75-2.18).361.60 (0.99-2.60).052.04 (1.17-3.55).01
Education
    Did not complete HS/HS graduate1.001.001.001.00
    Some college or above0.62 (0.31-1.21).160.64 (0.38-1.09).101.26 (0.75-2.11).380.81 (0.46-1.43).47
Household income, $
    > 60 000/y1.001.001.001.00
    20 000-60 000/y3.28 (1.41-7.59).012.12 (1.21-3.71).011.92 (1.21-3.05).012.04 (1.11-3.74).02
    < 20 000/y3.22 (1.08-9.64).043.10 (1.56-6.19)< .0012.28 (1.23-4.24).012.54 (1.21-5.35).01
Health insurance
    Yes1.001.001.001.00
    No0.87 (0.31-2.43).801.16 (0.59-2.32).661.20 (0.61-2.37).601.35 (0.66-2.78).42
Marital status
    Married1.001.001.001.00
    No0.82 (0.42-1.59).551.45 (0.88-2.37).141.02 (0.65-1.57).951.28 (0.76-2.17).35
Health status
    Excellent/good1.001.001.001.00
    Fair/poor3.80 (2.03-7.12)< .00013.56 (2.20-5.74)< .00015.58 (3.71-8.39)< .00015.98 (3.65-9.81)< .0001
Chronic health condition
    None1.001.001.001.00
    Grade1/21.36 (0.68-2.73).391.48 (0.88-2.48).141.44 (0.91-2.28).121.21 (0.70-2.10).49
    Grade3/41.39 (0.57-3.38).471.49 (0.76-2.90).241.91 (1.09-3.36).021.37 (0.68-2.74).38
Risk of relapse at HCT
    Standard risk1.001.001.001.00
    High risk1.18 (0.64-2.20).590.75 (0.46-1.21).230.95 (0.63-1.43).810.77 (0.46-1.28).31
Age at HCT, year (per 10 y)0.91 (0.70-1.20).520.80 (0.66-0.98).030.98 (0.82-1.17).860.88 (0.71-1.09).25
Time since HCT (per 10 y)0.62 (0.29-1.29).200.55 (0.32-0.93).030.56 (0.35-0.92).020.56 (0.31-0.99).05
Primary cancer diagnosis
    CML1.001.001.001.00
    AML/ALL1.32 (0.60-2.92).491.19 (0.69-2.08).530.94 (0.57-1.54).790.92 (0.50-1.67).78
    HL/NHL0.99 (0.41-2.38).990.61 (0.31-1.19).140.68 (0.39-1.17).160.82 (0.42-1.60).56
    SAA/MM/others0.95 (0.33-2.69).920.59 (0.26-1.35).210.65 (0.33-1.29).220.65 (0.28-1.52).32
Stem cell donor
    Autologous HCT1.001.001.001.00
    Allogeneic, sibling donor1.35 (0.67-2.71).401.41 (0.85-2.33).191.28 (0.82-2.01).281.41 (0.81-2.46).22
    Allogeneic, unrelated donor1.61 (0.61-4.26).340.82 (0.36-1.87).641.60 (0.86-2.96).141.42 (0.65-3.08).38
Transplant regimens
    Chemotherapy alone1.001.001.001.00
    Total body irradiation–based1.63 (0.75-3.53).221.96 (1.06-3.63).031.63 (0.98-2.71).061.98 (1.03-3.80).04
cGVHD (among allogeneic HCT survivors only)
    No1.001.001.001.00
    Active cGVHD1.69 (0.66-4.33).271.47 (0.69-3.14).322.00 (1.03-3.89).042.20 (1.01-4.79).05
    Resolved cGVHD0.44 (0.15-1.33).151.49 (0.76-2.93).250.99 (0.51-1.93).981.13 (0.53-2.41).75
Any immunosuppression (among allogeneic HCT survivors only)
    Methotrexate1.50 (0.54-4.19).440.66 (0.33-1.31).231.31 (0.66-2.58).440.79 (0.38-1.64).53
    Cyclosporine0.97 (0.32-2.91).952.93 (1.15-7.49).021.00 (0.46-2.20)1.001.31 (0.53-3.27).56
    Prednisone2.62 (1.11-6.19).032.27 (1.24-4.18).011.80 (1.04-3.11).042.28 (1.19-4.36).01
  • Primary diagnosis, stem cell donor, transplant regimens, chronic GVHD, and use of immunosuppressants were included in the model one at a time. Adjusted for sex, age at study participation (continuous), race/ethnicity (non-Hispanic white, others), marital status (married, not married), income (< $20 000/y, 20 000-60 000/y, > 60 000/y), education (did not complete high school/high-school graduate, some college or above), insurance status (yes, no) and health status (poor/fair, good/excellent), grade of chronic health conditions (none, grade 1 or 2, grade 3 or 4).

  • HCT indicates hematopoietic cell transplantation; OR, odds ratio; CI, confidence interval; HS, high school; CML, chronic myeloid leukemia; AML, acute myeloid leukemia; ALL, acute lymphoid leukemia; HL, Hodgkin lymphoma; NHL, non-Hodgkin lymphoma; SAA, severe aplastic anemia; MM, multiple myeloma; and cGVHD, chronic GVHD.