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. 2023 Nov;32(8):1134-1144.
doi: 10.1177/10547738231180337. Epub 2023 Jun 16.

Decisional Regret in Long-Term Australian Allogeneic Hematopoietic Stem Cell Transplantation Survivors: A Cross-Sectional Survey

Gemma McErlean  1   2 , Caley Tapp  3   4 , Lisa Brice  5 , Anisha Pradhan  1 , Nicole Gilroy  2   6 , Masura Kabir  7 , Matt Greenwood  5   8 , Stephen R Larsen  9 , John Moore  10 , David Gottlieb  6   8 , Mark Hertzberg  11 , Louisa Brown  12 , Megan Hogg  6 , Gillian Huang  6 , Christopher Ward  5   8 , Ian Kerridge  5   8
Affiliations

Decisional Regret in Long-Term Australian Allogeneic Hematopoietic Stem Cell Transplantation Survivors: A Cross-Sectional Survey

Gemma McErlean et al. Clin Nurs Res. 2023 Nov.

Abstract

Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is an intensive but effective treatment for malignant and non-malignant diseases. However, long-term survival often comes at a cost, with survivors experiencing chronic morbidity and are at risk of relapse and secondary malignancy. This study aimed to describe decisional regret in a large cohort of Australian long-term allo-HSCT survivors. A cross-sectional survey was conducted with 441 adults in New South Wales, assessing quality of life (QoL), psychological, social, demographic, and clinical variables. Less than 10% of survivors expressed regret, with chronic graft-versus-host disease being the most important clinical factor. Psycho-socioeconomic factors such as depression, lower QoL scores, lower household income, higher treatment burden, and not resuming sex post-HSCT were also associated with regret. Findings highlight the need for valid informed consent and ongoing follow-up and support for allo-HSCT survivors dealing with life post-transplant. Nurses and healthcare professionals play a critical role in addressing decisional regret in these patients.

Keywords: allogeneic transplant; bone marrow transplantation; cancer; decisional regret; hematopoietic stem cell transplant; psychosocial; survivorship.

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Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

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