{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T08:09:22Z","timestamp":1790237362195,"version":"4.1.0"},"reference-count":30,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"3","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO Oncol Pract"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:sec><jats:title>PURPOSE<\/jats:title><jats:p> We investigated the prevalence of financial toxicity in a population undergoing hematopoietic cell transplantation (HCT) evaluation and measured its impact on post-transplant clinical and health-related quality-of-life outcomes. <\/jats:p><\/jats:sec><jats:sec><jats:title>MATERIALS AND METHODS<\/jats:title><jats:p> This was a prospective study in patients undergoing evaluation for allogeneic HCT between January 1, 2018, and September 23, 2020, at a large academic medical center. Financial health was measured via a baseline survey and the comprehensive score for financial toxicity-functional assessment of chronic illness therapy (COST-FACIT) survey. The cohort was divided into three groups: none (grade 0), mild (grade 1), and moderate-high financial toxicity (grades 2-3). Health-related quality of life outcomes were measured at multiple time points. Multivariate logistic regression analysis evaluated factors associated with financial toxicity. Kaplan-Meier curves and log-rank tests was used to evaluate overall survival (OS) and nonrelapse survival. <\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p> Of 245 patients evaluated for transplant, 176 (71.8%) completed both questionnaires (median age was 57 years, 63.1% were male, 72.2% were White, and 39.2% had myelodysplastic syndrome, 38.1% leukemia, and 13.6% lymphoma). At initial evaluation, 83 (47.2%) patients reported no financial toxicity, 51 (29.0%) with mild, and 42 (23.9%) with moderate-high financial toxicity. Patients with financial toxicity reported significant cost-cutting behaviors, including reduced spending on food or clothing, using their savings, or not filling a prescription because of costs ( P &lt; .0001). Quality of life was lower in patients with moderate-high financial toxicity at 6 months ( P = .0007) and 1 year ( P = .0075) after transplant. Older age (&gt;62; odds ratio [OR], 0.33 [95% CI, 0.13 to 0.79]; P = .04) and income \u2265$60,000 in US dollars (USD) (OR, 0.17 [95% CI, 0.08 to 0.38]; P &lt; .0001) were associated with lower odds of financial toxicity. No association was noted between financial toxicity and selection for transplant, OS, or nonrelapse mortality. <\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSION<\/jats:title><jats:p> Financial toxicity was highly correlated with patient-reported changes in compensatory behavior, with notable impact on patient quality of life after transplant. <\/jats:p><\/jats:sec>","DOI":"10.1200\/op.23.00243","type":"journal-article","created":{"date-parts":[[2023,12,21]],"date-time":"2023-12-21T21:02:10Z","timestamp":1703192530000},"page":"351-360","update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":20,"title":["Financial Toxicity and Quality of Life in Patients Undergoing Stem-Cell Transplant Evaluation: A Single-Center Analysis"],"prefix":"10.1200","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8006-5343","authenticated-orcid":true,"given":"S.M. Qasim","family":"Hussaini","sequence":"first","affiliation":[{"name":"O'Neal Comprehensive Cancer, University of Alabama at Birmingham, Birmingham, AL"},{"name":"Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins Hospital, Baltimore, MD"},{"name":"Department of Medicine, Duke University School of Medicine, Durham, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Ren","sequence":"additional","affiliation":[{"name":"Duke Cancer Institute Biostatistics Shared Resource, Durham, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Racioppi","sequence":"additional","affiliation":[{"name":"Department of Medicine, Duke University School of Medicine, Durham, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meagan V.","family":"Lew","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\/0000-0001-8249-6801","authenticated-orcid":true,"given":"Ernaya","family":"Johnson","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"}]},{"given":"Yan","family":"Li","sequence":"additional","affiliation":[{"name":"Duke Cancer Institute Biostatistics Shared Resource, Durham, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jillian C.","family":"Thompson","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"}]},{"given":"Bethany","family":"Henshall","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"}]},{"given":"Maurisa","family":"Darby","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\/0000-0003-3776-2407","authenticated-orcid":true,"given":"Taewoong","family":"Choi","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"}]},{"given":"Richard D.","family":"Lopez","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"}]},{"given":"Stefanie","family":"Sarantopoulos","sequence":"additional","affiliation":[{"name":"Duke Cancer Institute Biostatistics Shared Resource, Durham, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Gasparetto","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"}]},{"given":"Gwynn D.","family":"Long","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\/0000-0001-9863-8464","authenticated-orcid":true,"given":"Mitchell E.","family":"Horwitz","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"}]},{"given":"Nelson J.","family":"Chao","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\/0000-0002-9039-5258","authenticated-orcid":true,"given":"S. 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