Pain in older survivors of hematologic malignancies after blood or marrow transplantation: A BMTSS report

Naveed Farrukh, Lindsey Hageman, Yanjun Chen, Jessica Wu, Emily Ness, Michelle Kung, Liton Francisco, Mariel Parman, Wendy Landier, Mukta Arora, Saro Armenian, Smita Bhatia, Grant R. Williams

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Blood or marrow transplantation (BMT) is increasingly offered to older adults with hematologic malignancies; however, their risk for severe pain is poorly understood. Using the Bone Marrow Transplant Survivor Study, the current study investigated the prevalence and predictors of pain after BMT (allogeneic or autologous) as well as its association with physical performance impairments and frailty. Methods: The cohort included 736 patients with hematologic malignancies who underwent BMT at an age ≥ 60 years at 1 of 3 transplant centers between 1974 and 2014 and survived ≥2 years after BMT; 183 unaffected siblings also participated. Study participants reported on 4 pain domains (nonminor everyday pain, moderate to severe bodily pain, prolonged pain, and moderate to extreme pain interference), and the presence of 1 or more domains was indicative of a severe and/or life-interfering pain composite variable. Results: Overall, 39.4% of the BMT survivors reported severe pain with 2.6-fold greater odds of reporting pain in comparison with sibling controls. Among BMT recipients, those with less education, lower incomes, and active chronic graft-versus-host disease had higher odds of reporting pain. In multivariable analyses, BMT survivors with pain were more likely to have impaired physical performance and were more likely to meet the frailty criteria. BMT survivors reported higher use of pain medications (17.8% vs 9.3%) and opioid pain medications (6.5% vs 2.2%) in comparison with sibling controls. Conclusions: Nearly 40% of older BMT survivors who were followed for a median of 5 years after BMT reported pain, and BMT survivors had 2.6-fold higher odds of reporting severe, nonminor or life-interfering pain in comparison with siblings.

Original languageEnglish (US)
Pages (from-to)2003-2012
Number of pages10
JournalCancer
Volume126
Issue number9
DOIs
StatePublished - Jan 1 2020

Bibliographical note

Funding Information:
This work was supported in part by grants from the National Institutes of Health (R01 CA078938 and U01 CA213140 [Smita Bhatia] and K08CA234225 [Grant R. Williams]) and the Leukemia & Lymphoma Society (2191‐02, 6256‐13, and R6502‐16 [Smita Bhatia]). The content is solely the responsibility of the authors and does not necessarily represent the official view of the National Institutes of Health.

Publisher Copyright:
© 2020 American Cancer Society

Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.

Keywords

  • aging
  • blood or marrow transplantation
  • geriatric oncology
  • opioids
  • pain

PubMed: MeSH publication types

  • Journal Article
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

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