Lack of a caregiver is associated with shorter survival in myeloma patients undergoing autologous stem cell transplantation

Abstract

There is increasing evidence that social infrastructure and a healthy social network can improve cancer survival. Mayo Clinic has an outpatient stem cell transplantation program for myeloma. Safe outpatient transplantation requires a caregiver to be present. Patients lacking a caregiver are transplanted as an inpatient. We reviewed outcomes on over 2000 patients with multiple myeloma, 2103 transplanted as an outpatient compared with 41 hospitalized for transplantation. Although progression-free survival following transplantation was identical between the two groups, overall survival was shorter in those hospitalized. This suggests that the absence of a caregiver for transplantation is an important surrogate of the social infrastructure associated with poor outcomes in transplanted patients with multiple myeloma

Keywords:

• Multiple myeloma
• stem cell transplantation
• social connectedness
• family support
• cancer outcomes

Disclosure statement

MAG personal fees from Ionis/Akcea, personal fees from Alnylam, personal fees from Prothena, personal fees from Sanofi, personal fees from Janssen, grants and personal fees from Spectrum, personal fees from Annexon, personal fees from Appellis, personal fees from Amgen, personal fees from Medscape, personal fees from Physicians Education Resource, personal fees for Data Safety Monitoring board from Abbvie, and Celgene personal fees from Research to Practice, Speaker fees from Johnson and Johnson; Speaker fees from Medscape, Speaker fees DAVA oncology; Advisory Board for Pharmacyclics Advisory Board for Proclara outside the submitted work; Development of educational materials for i3Health; Kapoor Sanofi Advisory Board Abbvie Advisory Board Oncopeptites Advisory Board Pharmacyclics, Advisory Board BeiGene, Advisory Board GSK Advisory Board Cellectar Advisory Board. Kumar Research funding for clinical trials to the institution: Abbvie, Amgen, BMS, Carsgen, Janssen, Astra-Zeneca, Novartis, Roche-Genentech, Takeda, Tenebio, Molecular Templates, Abbvie, Amgen, BMS, Janssen, Roche-Genentech, Takeda, Astra-Zeneca, Bluebird Bio, Epizyme, Secura Biotherapeutics, Monterosa therapeutics, Trillium and (with personal payment) Oncopeptides, Beigene, Antengene, GLH Pharma, and rest of the authors declare they have no conflict of interest.

Code availability

Statistics done on JMP software.

Data availability statement

The datasets generated during and/or analyzed during the current study are not publicly available due to patient privacy laws but are available from the corresponding author on reasonable request.

Authors' contributions

All authors contributed to patients and reviewed and edited the manuscript.

Additional information

Funding

This work was supported by the NCI SPORE MM SPORE 5P50 CA186781-04.