Patient preferences for allogeneic haematopoietic stem cell transplantation: how much benefit is worthwhile from the pat
- PDF / 524,583 Bytes
- 7 Pages / 595.276 x 790.866 pts Page_size
- 82 Downloads / 187 Views
ORIGINAL ARTICLE
Patient preferences for allogeneic haematopoietic stem cell transplantation: how much benefit is worthwhile from the patient’s perspective? Nicolas Leuthold 1 & Marco Cattaneo 2 & Jörg Halter 3 & Claudia Hügli 4 & Monika Kirsch 5 & Anna Petropoulou 6 & Tobias E. Erlanger 2 & Sabine Gerull 3 & Jakob Passweg 3 & Alix O’Meara Stern 1,6 Received: 18 April 2020 / Accepted: 7 October 2020 # The Author(s) 2020
Abstract Oncological studies have shown that patients consider small benefits sufficient to make adjuvant chemotherapy worthwhile. We sought to determine the minimal survival benefits that patients considered enough to legitimate allogeneic haematopoietic stem cell transplantation (HCT) and the factors associated with patient preferences. One hundred eighty-four patients having previously received allogeneic HCT at our centre were included and completed a questionnaire exploring patient expectations elicited by time trade-off scenarios as well as quality of life (QoL), symptoms of graft-versus host disease (GvHD) and sociodemographic characteristics. The majority of patients considered a minimal survival benefit of at least 5 (38.6%) or 10 years (41.9%) sufficient to justify HCT, with less than 5% considering survival < 1 year sufficient to warrant HCT. In terms of minimal cure rate, a cumulative 14.8% of patients accepted cure rates below 30% and 30.6% rates below 50%. Likelihood-ratio tests were significant for the effect of age at transplant on expected minimal survival (p = 0.007) and cure rates (p = 0.0001); that is, younger patients at HCT were more likely to accept smaller survival and cure rates. Pre-transplant risk score, QoL, GvHD score and sociological factors did not seem to influence patients’ expectations. In conclusion, patient expectations of treatment were much higher than what had been reported in oncological studies. Patients who experienced HCT considered a survival superior to 1 year and cure rates above 50% sufficient to make it worthwhile. Younger patients were more likely to accept smaller benefits; no other predictors for preferences could be detected. Keywords Patient preferences . Decision-making . Allogeneic stem cell transplantation . Graft-versus-host disease
Introduction * Alix O’Meara Stern [email protected] 1
University of Basel, Basel, Switzerland
2
Department of Clinical Research, University of Basel and University Hospital Basel, Basel, Switzerland
3
Division of Haematology, University Hospital Basel, Basel, Switzerland
4
Department of Pediatric Oncology, Haematology and Immunology, University of Heidelberg, Heidelberg, Germany
5
Department of Anaesthesia, University Hospital Basel, Basel, Switzerland
6
Department of Oncology, Cantonal Hospital Neuchâtel, Neuchâtel, Switzerland
Allogeneic haematopoietic stem cell transplantation (HCT) is a procedure that aims at curing a wide array of diseases ranging from myeloid and lymphoid neoplasia to non-malignant disorders. Cure rates of up to 70% can be achieved depending on the underlying disease, patient,
Data Loading...
