Significant Amount of Patients Remain on Sick Leave 1 Year Following Allo-HSCT, Study Says

Following allogeneic hematopoietic stem cell transplantation (allo-HSCT), the majority of patients go on sick leave, according to new study findings that followed patients for a year after the procedure.

The findings showed that between 2009 to 2016, 76% of the 122 patients included in the study were on sick leave a year following their allo-HSCT. Moreover, 39% of patients were on full-time sick leave; at the time of transplantation nearly all patients were on full-time leave.

According to the researchers, the high proportion of patients on sick leave may be attributed to clinicians recommending that patients take full-time leave for at least 6 months, unless they can easily adapt their work to reduce the risk of infection. Clinicians may recommend even longer leave if the patient is still immunosuppressed for graft-versus-host-disease (GVHD) at 6 months post transplantation.

Looking at factors that may have a connection to sick leave, the researchers found in their multivariate analysis that chronic GVHD (cGVHD) and symptoms for depression may be indicators of sick leave 1 year following transplantation (odds ratio [OR], 3.43; 95% CI, 1.35-8.73; P = .01)

“These results suggest that it is important for health care staff to closely monitor and manage the consequences of cGvHD and be observant of and find appropriate care strategies for patients’ symptoms of depression in the aftermath of allo-HSCT to increase the likelihood of a successful [return to work],” explained the researchers.

Notably, the researchers found that having depressive symptoms at 7 months following allo-HSCT, not at baseline, was associated with full-time sick leave (OR, 3.37; 95% CI, 1.2–11.58; P = 0.02).

They argue that more in-depth research into understanding how depression can affect allo-HSCT outcomes should be of interest.

“No previous studies have been found that specifically explore associations between depression and SL after allo-HSCT,” wrote the researchers. “However, although it is known that depression negatively affects RTW after injury or illness in general, this has not been shown among patients with a haematological malignancy. Nevertheless, one study indicated that being unemployed is linked to depression after allo-HSCT.”

Another factor associated with sick leave 1 year after transplantation in univariate analyses, but not in the multivariate analysis, was low vocational satisfaction (OR, 3.27; 95% CI 1.27– 8.41; P = .01), which the researchers say is in line with studies of other cancer types, including breast cancer.

Reference

Eriksson L, Wennman-Larsen A, Bergkvist K, Ljungman P, Winterling J. Important factors associated with sick leave after allogeneic haematopoietic stem cell transplantation—a 1-year prospective study. J Cancer Surviv. 2021;15:933-941. doi:10.1007/s11764-020-00986-5