Annual household income and chronic pulmonary conditions in long-term survivors of blood or marrow transplantation: a BMTSS report.

INTRODUCTION

Whether socioeconomic status is associated with pulmonary conditions in BMT survivors is unknown. In this study, we used data from the BMT Survivor Study (BMTSS) to determine the association between low annual household income and adverse pulmonary conditions (asthma, chronic cough or dyspnea, dyspnea at rest, recurrent pneumonia, current oxygen use) and health status in a retrospective cohort of BMT survivors.

METHODS

BMTSS includes individuals who received BMT between 1974 and 2014 and survived for ≥ 2y after BMT at one of three participating sites. BMT survivors completed the BMTSS survey, providing details on demographics (including annual household income) and chronic health conditions as diagnosed by their healthcare providers. We used logistic regression models to determine the odds of low annual household income (≤$49,999) associated with a post-BMT pulmonary condition in BMT survivors, adjusting for relevant clinical and sociodemographic variables.

RESULTS

Our analysis included 2,814 participants (median age 58y; 44% female; 75% non-Hispanic White). Compared to survivors with annual household income ≥$100,000, those with income ≤$49,999 had higher odds of pulmonary conditions (asthma: OR = 1.80, 95%CI = 1.04-3.12, chronic cough or dyspnea: OR = 1.96, 95%CI = 1.37-2.81, and recurrent pneumonia: OR = 1.90, 95%CI = 1.00-3.60. Low income was also associated with suboptimal health status (poor/fair/good: OR = 2.36, 95%CI = 1.84-3.01; reference: very good/excellent).

CONCLUSIONS

The association between low annual household income and post-BMT pulmonary compromise in BMT survivors presents a need to understand the individual and environmental causes for this association. Future research should evaluate interventions to prevent post-transplant pulmonary morbidity in the lower-income survivor population.