The socioeconomic and psychosocial circumstances of adult long-term survivors of hematopoietic stem cell transplantation in childhood

Socioeconomic factors such as education, employment, financial circumstances, marital status, and psychological well-being were investigated in 51 Swedish adults (age 19-42) surviving for at least five yr following pediatric allogeneic SCT (age at SCT 1-16 yr) using items derived from a Living Condition Survey (ULF). Psychological well-being and cognitive faculties were measured by HAD and SWED-QUAL. Socioeconomic data and marital status were compared with a norm group matched for gender and age, derived from the Swedish national population registry. Most subjects function well and lead normal lives, and they are nevertheless more likely than the norm to encounter problems with establishing themselves on the labor market. The SCT group demonstrated a lower level of employment, and the likelihood of having a disability pension was higher than in the normal population. Younger subjects and women encountered most financial difficulties and a higher risk of poverty. Cognitive difficulties intercorrelated both with inferior financial circumstances and with higher levels of anxiety and depression. These results indicate the importance of recognizing and attempting to tackle the possible cumulative disadvantage of problems that affect the adult following SCT in childhood.