Division of Hematology, University Hospital of Basel, Basel, Switzerland.
Bone Marrow Transplant. 2017 Oct;52(10):1436-1442. doi: 10.1038/bmt.2017.115. Epub 2017 Jun 26.
Return to work is critical goal following HSCT. However, late effects may impede return to normal activity after HSCT. In the case of inability to work, patients may need a work disability pension to ensure a reasonable livelihood. This study evaluated inability to work and need for disability pension among long-term survivors and analyzed possible determinants of need for social support. This retrospective, single-center study included all HSCT patients surviving ⩾5 years seen at the outpatient clinic between January 2013 and August 2015. There were 203 patients, median age at HSCT 35 years, and 50 years at time of study; median time between HSCT and study control was 12 years; 178 had allo-HSCT, 187 had a malignant disease. At time of study, 156 (77%) were working full or part-time, 47 (23%) were not working. In total, 76 (37%) survivors were receiving a work disability pension compared to 3.17% of the Swiss working population. Patients with a disability pension were significantly older at HSCT, were more often living alone, had more active physical and mental late effects, and higher score of fatigue compared to patients without. These findings underline the importance of screening for employment and the social consequences of non-employment in long-term survivors after HSCT.
重返工作岗位是 HSCT 后的关键目标。然而,晚期效应可能会阻碍 HSCT 后恢复正常活动。如果无法工作,患者可能需要工作残疾抚恤金来确保合理的生计。本研究评估了长期幸存者无法工作和需要残疾抚恤金的情况,并分析了社会支持需求的可能决定因素。这项回顾性、单中心研究包括了 2013 年 1 月至 2015 年 8 月在门诊接受治疗、存活时间 ⩾5 年的所有 HSCT 患者。共有 203 名患者,HSCT 时的中位年龄为 35 岁,研究时的中位年龄为 50 岁;HSCT 与研究对照之间的中位时间为 12 年;178 名患者接受了同种异体 HSCT,187 名患者患有恶性疾病。在研究时,156 名(77%)全职或兼职工作,47 名(23%)不工作。共有 76 名(37%)幸存者领取工作残疾抚恤金,而瑞士工作人口中这一比例为 3.17%。领取残疾抚恤金的患者在 HSCT 时年龄明显更大,独居的患者更多,身体和精神的晚期效应更活跃,疲劳评分也更高。这些发现强调了对 HSCT 后长期幸存者进行就业和非就业社会后果筛查的重要性。