{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T21:00:17Z","timestamp":1790197217459,"version":"4.1.0"},"reference-count":36,"publisher":"American Society of Clinical Oncology (ASCO)","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO Oncol Pract"],"abstract":"<jats:sec>\n                    <jats:title>PURPOSE<\/jats:title>\n                    <jats:p>Financial toxicity is common after bone marrow transplant (BMT) and is associated with worse quality of life, but longitudinal patterns remain poorly understood.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>We conducted a prospective cohort study of insured adults undergoing allogeneic BMT (2018-2023). Financial toxicity (Comprehensive Score for Financial Toxicity-Functional Assessment of Chronic Illness Therapy) and quality of life (Functional Assessment of Cancer Therapy [FACT]\u2013General, FACT-BMT) were assessed at baseline and at days (D) 90, 180, and 365. Longitudinal trends were analyzed using mixed-effects models. Relative risks (RR) for financial toxicity and hazard ratios (HR) for post-BMT mortality were estimated using generalized linear mixed-effects and time-varying Cox models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Among 214 transplanted patients, the median age was 58 years (IQR 46-66 year), 62% were male, and 80% were White; 47% had leukemia, 27% myelodysplastic syndrome, and 9% lymphoma; and 31% died by D365. At baseline, 56% reported none\/minimal, 26% mild, and 18% moderate\/high financial toxicity. Financial toxicity was associated with more cost-cutting behaviors, including reduced spending on food or clothing, use of savings, and prescription nonadherence. Expected probability of \u2265mild financial toxicity reduced over time (39% baseline, 34% D90, 30% D180, 26% D365). Across time points, age &gt;65 years and income &gt;$90,000 in US dollars (USD) had 66% and 67% decreased risk of financial toxicity, respectively, compared with counterparts (n = 148, RR, 0.34, 95% CI [0.19 to 0.59]; RR, 0.33 [0.20 to 0.57]). Quality of life (n = 119 alive and with data by D365) with none\/minimal or mild financial toxicity improved after transplant compared with baseline but significantly worsened for those with moderate\/high financial toxicity over 1 year. Following adjustment for covariables, financial toxicity was not significantly associated with premature death after transplant (n = 214, HR, 1.10 [0.62-1.96]).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>Financial toxicity improved overtime with BMT, but persistent financial hardship was associated with quality of life. These findings support longitudinal screening and financial interventions across the transplant continuum.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1200\/op-26-00421","type":"journal-article","created":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T19:59:15Z","timestamp":1790193555000},"update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":0,"title":["Financial Toxicity and Quality of Life After Bone Marrow Transplant: A Longitudinal, Prospective Study"],"prefix":"10.1200","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8006-5343","authenticated-orcid":true,"given":"S. M. Qasim","family":"Hussaini","sequence":"first","affiliation":[{"name":"Division of Hematology &amp; Oncology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL"},{"name":"O'Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9071-6920","authenticated-orcid":true,"given":"Supriya","family":"Maheshwari","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of Alabama at Birmingham, Birmingham, AL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luqin","family":"Deng","sequence":"additional","affiliation":[{"name":"UAB Division of General Internal Medicine and Population Science, Birmingham, AL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6383-5994","authenticated-orcid":true,"given":"Sanghee","family":"Hong","sequence":"additional","affiliation":[{"name":"Division of Hematologic Malignancies and Cellular Therapy, Department of Medicine, Duke University School of Medicine, Durham, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9197-3830","authenticated-orcid":true,"given":"Lauren","family":"Bohannon","sequence":"additional","affiliation":[{"name":"Division of Hematologic Malignancies and Cellular Therapy, Department of Medicine, Duke University School of Medicine, Durham, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9767-1158","authenticated-orcid":true,"given":"Dinesh Pal","family":"Mudaranthakam","sequence":"additional","affiliation":[{"name":"Department of Biostatistics &amp; Data Science, University of Kansas Medical Center, Kansas City, KS"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9938-4830","authenticated-orcid":true,"given":"Rachel","family":"Forcino","sequence":"additional","affiliation":[{"name":"The Department of Population Health, University of Kansas Medical Center, Kansas City, KS"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7906-8782","authenticated-orcid":true,"given":"Manuel R.","family":"Espinoza-Gutarra","sequence":"additional","affiliation":[{"name":"Division of Hematology &amp; Oncology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL"},{"name":"O'Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9883-1424","authenticated-orcid":true,"given":"Andres","family":"Azuero","sequence":"additional","affiliation":[{"name":"School of Nursing, University of Alabama at Birmingham, Birmingham, AL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5328-7517","authenticated-orcid":true,"given":"Courtney P.","family":"Williams","sequence":"additional","affiliation":[{"name":"O'Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL"},{"name":"UAB Division of General Internal Medicine and Population Science, Birmingham, AL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4188-9785","authenticated-orcid":true,"given":"Gabrielle B.","family":"Rocque","sequence":"additional","affiliation":[{"name":"Division of Hematology &amp; Oncology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL"},{"name":"O'Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony D.","family":"Sung","sequence":"additional","affiliation":[{"name":"Department of Medicine, Duke University School of Medicine, Durham, NC"},{"name":"Division of Hematologic Malignancies and Cellular Therapeutics, University of Kansas Medical Center, Kansas City, KS"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"233","published-online":{"date-parts":[[2026,9,23]]},"reference":[{"key":"e_1_3_7_2_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41409-022-01691-w"},{"key":"e_1_3_7_3_2","doi-asserted-by":"publisher","DOI":"10.1038\/bmt.2012.133"},{"key":"e_1_3_7_4_2","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2023011033"},{"key":"e_1_3_7_5_2","first-page":"366","article-title":"The cost of hematopoietic stem-cell transplantation in the United States","volume":"10","author":"Broder MS","year":"2017","unstructured":"Broder MS, Quock TP, Chang E, et al: The cost of hematopoietic stem-cell transplantation in the United States. 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