BACKGROUND Allogeneic hematopoietic stem cell transplantation (alloHCT) is potentially curative but with known negative effects on quality of life. In the current study, the authors investigated whether patients expressed regret after undergoing HCT and the relationships between clinical outcomes and quality of life. METHODS Center for International Blood and Marrow Transplant Research data from 184 adults who completed the Functional Assessment of Cancer Therapy-Bone Marrow Transplant (FACT-BMT) before undergoing alloHCT and at day 100 were used. Additional time points were 6 months and 12 months. Regret was measured using a FACT-BMT item not included in scoring: "I regret having the bone marrow transplant." The authors evaluated FACT-BMT scores and regret using Student t-tests. Covariance pattern models were used to determine predictors of regret over time, including baseline characteristics and post-alloHCT outcomes (acute or chronic graft-versus-host-disease, disease recurrence). RESULTS At 100 days, 6 months, and 12 months, approximately 6% to 8% of patients expressed regret; a total of 15% expressed regret at any time point. Regret was found to be associated with lower FACT-BMT scores at 6 months and 12 months (P < .001). Higher baseline FACT-BMT and social well-being scores were associated with a reduced risk of expressing regret. The risk of regretting transplantation was 17.5 percentage points (95% confidence interval, 5.5-29.7 percentage points) greater in patients who developed disease recurrence after HCT compared with patients who did not. CONCLUSIONS Among patients who underwent alloHCT and lived to 100 days, the majority did not report regretting their transplantation. Regret was found to be related to disease recurrence. Social connectedness may serve as a protective factor against later regret. Future work should explore regret in other patient groups and use qualitative methods to inform best practices for reducing regret.

中文翻译：

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接受异基因造血干细胞移植的患者决策后悔的普遍性以及与生活质量和临床结果的关联。

背景同种异体造血干细胞移植（alloHCT）具有潜在的治愈作用，但已知对生活质量有负面影响。在目前的研究中，作者调查了患者在接受 HCT 后是否表示后悔以及临床结果与生活质量之间的关系。方法 国际血液和骨髓移植研究中心的数据来自 184 名成年人，他们在接受 alloHCT 之前和第 100 天完成了癌症治疗 - 骨髓移植的功能评估 (FACT-BMT)。额外的时间点是 6 个月和 12 个月。遗憾是使用未包含在评分中的 FACT-BMT 项目来衡量的：“我后悔进行了骨髓移植。” 作者使用学生 t 检验评估了 FACT-BMT 分数和遗憾。协方差模式模型用于确定随时间变化的后悔预测因素，包括基线特征和 alloHCT 后结果（急性或慢性移植物抗宿主病、疾病复发）。结果 在 100 天、6 个月和 12 个月时，大约 6% 至 8% 的患者表示后悔；共有 15% 的人在任何时间点都表示后悔。发现遗憾与 6 个月和 12 个月时较低的 FACT-BMT 评分相关（P < .001）。较高的基线 FACT-BMT 和社会福利得分与表达后悔的风险降低有关。HCT 后出现疾病复发的患者与未复发的患者相比，后悔移植的风险高 17.5 个百分点（95% 置信区间，5.5-29.7 个百分点）。结论 在接受 alloHCT 并活到 100 天的患者中，大多数没有报告后悔他们的移植。发现后悔与疾病复发有关。社会联系可以作为防止以后后悔的保护因素。未来的工作应该探索其他患者群体的遗憾，并使用定性方法为减少遗憾的最佳实践提供信息。