Health-Related Quality of Life Following Allogeneic Hematopoietic Cell Transplantation with Omidubicel versus Umbilical Cord Blood.
Cellular therapy
Cord blood
Quality of life
Stem cell transplantation
Journal
Transplantation and cellular therapy
ISSN: 2666-6367
Titre abrégé: Transplant Cell Ther
Pays: United States
ID NLM: 101774629
Informations de publication
Date de publication:
01 2023
01 2023
Historique:
received:
11
08
2022
accepted:
23
09
2022
pmc-release:
01
01
2024
pubmed:
1
10
2022
medline:
11
1
2023
entrez:
30
9
2022
Statut:
ppublish
Résumé
Omidubicel is an advanced cell therapy derived from umbilical cord blood (UCB) for use in allogeneic hematopoietic cell transplantation (HCT). A recent randomized phase 3 clinical trial demonstrated faster engraftment, shorter length of hospital stays, and lower rates of infection with omidubicel compared with standard UCB transplantation in patients with high-risk hematologic malignancies. Despite the proven clinical benefits of omidubicel, its impact on health-related quality of life (HRQL) from the patient's perspective has not been described. This study analyzed patient-reported HRQL measures collected prospectively in the randomized phase 3 trial comparing omidubicel to standard UCB transplantation. A total of 108 patients at 33 international stem cell transplantation centers underwent myeloablative allogeneic HCT with either omidubicel or standard UCB. Patients completed serial HRQL questionnaires at screening and on days 42, 100, 180, and 365 post-transplantation. The HRQL surveys included the Functional Assessment of Cancer Therapy-Bone Marrow Transplant (FACT-BMT), a 50-item cancer-specific questionnaire assessing physical, functional, emotional, social/family, and HCT-specific well-being, and the EuroQol 5-Dimension 3-Level, a 5-item generic HRQL survey. A mixed model with repeated measures was used to compare changes in HRQL from baseline in the 2 treatment arms. The average change in HRQL scores over time was compared by estimating the difference in the area under the curve (AUC) in each treatment group. Seventy-five patients (omidubicel arm, n = 37; standard UCB arm, n = 38) who completed the FACT-BMT at baseline and on 1 or more follow-up visits were included in this study. Baseline characteristics were similar in the 2 treatment arms. Over the first year post-transplantation, the AUCs of mean changes in physical, functional, and total FACT-BMT scores indicated significantly better HRQL with omidubicel (P < .05), with mean differences across time points ranging from 1.4 to 3.1 points, 1.6 to 3.2 points, and 7.2 to 11.0 points, respectively. The minimal clinically important difference was exceeded at 1 or more time points for each of these measures. The HRQL improvements with omidubicel were observed as early as 42 days post-transplantation and persisted at 1 year, indicating the potential long-term benefits of omidubicel on HRQL. Across all patients, adverse clinical outcomes, such as grade 3 viral infections and lower rates of neutrophil engraftment, were associated with worse HRQL scores. The observed improvements in HRQL measures may reflect the known clinical benefits of omidubicel. Compared with standard UCB, allogeneic HCT with omidubicel resulted in significant and clinically meaningful improvements in patient-reported HRQL measures.
Identifiants
pubmed: 36179986
pii: S2666-6367(22)01655-4
doi: 10.1016/j.jtct.2022.09.018
pmc: PMC9825638
mid: NIHMS1839094
pii:
doi:
Types de publication
Clinical Trial, Phase III
Randomized Controlled Trial
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
52.e1-52.e9Subventions
Organisme : NHLBI NIH HHS
ID : T32 HL007057
Pays : United States
Informations de copyright
Copyright © 2022 The American Society for Transplantation and Cellular Therapy. Published by Elsevier Inc. All rights reserved.
Références
JAMA Oncol. 2017 Jun 1;3(6):738-739
pubmed: 27658006
Cancer Med. 2020 Oct;9(20):7363-7374
pubmed: 32846465
Exp Hematol. 2012 Apr;40(4):342-55.e1
pubmed: 22198152
Bone Marrow Transplant. 1999 Oct;24(8):911-8
pubmed: 10516705
J Clin Invest. 2014 Jul;124(7):3121-8
pubmed: 24911148
Hematology Am Soc Hematol Educ Program. 2010;2010:248-54
pubmed: 21239801
Bone Marrow Transplant. 2010 Apr;45(4):746-54
pubmed: 19718073
Exp Hematol. 2019 Dec;80:11-15
pubmed: 31786243
J Patient Rep Outcomes. 2022 Apr 20;6(1):38
pubmed: 35441987
J Clin Oncol. 1993 Mar;11(3):570-9
pubmed: 8445433
Blood. 2009 Jul 2;114(1):7-19
pubmed: 19336756
Patient Relat Outcome Meas. 2018 Nov 01;9:353-367
pubmed: 30464666
Eur J Haematol. 2005 Apr;74(4):304-8
pubmed: 15777342
Biol Blood Marrow Transplant. 2016 Sep;22(9):1636-1645
pubmed: 27343716
Bone Marrow Transplant. 1997 Feb;19(4):357-68
pubmed: 9051246
Blood. 2021 Oct 21;138(16):1429-1440
pubmed: 34157093
Biol Blood Marrow Transplant. 2019 Feb;25(2):362-368
pubmed: 30287390
Biol Blood Marrow Transplant. 2019 Nov;25(11):2267-2273
pubmed: 31288096
Lancet Oncol. 2010 Jul;11(7):653-60
pubmed: 20558104
Eval Health Prof. 2005 Jun;28(2):172-91
pubmed: 15851772
Health Qual Life Outcomes. 2007 Dec 21;5:70
pubmed: 18154669