gene expression between HRV URTI and proven LRTI Figure1A.. Differential gene expression between HRV URTI and possi-ble LRTI was not as robust Figure 1B.. Principle component analysis of
Trang 1gene expression between HRV URTI and proven LRTI (Figure
1A) Differential gene expression between HRV URTI and
possi-ble LRTI was not as robust (Figure 1B) Principle component
analysis of the top 500 most variable genes demonstrated
sep-aration between subjects with HRV URTI and HRV proven LRTI
(Figure 2) GO enrichment analyses demonstrated enrichment
of terms associated with adaptive immune responses in the
URTI group (Table)
Conclusions: HRV URTI and proven LRTI have highly
differen-tial gene expression patterns, whereas possible LRTI gene
expression appears to more closely resemble that of URTI
Gene enrichment analysis demonstrates potential increased
immune activation in the URTI subjects, which may lead to
better control of infection Larger studies are needed to verify
thesefindings Whole blood RNA-seq is feasible and may be a
useful tool for demonstrating unique transcriptomic signatures
for clinical phenotypes in HCT recipients and for identifying
specific pathways in pathogenesis
LATE EFFECTS AND QUALITY OF LIFE
561 Application of Path-Goal and Transformational Leadership Theory to Improve Patient and Provider Satisfaction with APP-Led Survivorship Care: A Quality Improvement Initiative
Sasha Skendzel MSN, APRN, ACNP-BC1, Shernan G Holtan MD2, Patricia Finch-Guthrie PhD, RN3.1University of Minnesota, Minneapolis, MN;2Division of Hematology, Oncology, and Transplantation, University of Minnesota, Minneapolis, MN;
3Nursing, St Catherine University, St Paul, MN Introduction: A limited number of survivorship models have been implemented following theoretical frameworks to pro-mote patient and provider satisfaction The purpose of this quality improvement (QI) initiative was to evaluate both par-ties’ satisfaction with a newly implemented advanced practice provider (APP) led survivorship visit and apply theoretical principles of Path-Goal (PG) and Transformational Leadership (TL) to enhance outcomes
Methods: We surveyed a convenience sample (n = 11) of adult cancer survivors ages 36-75 undergoing survivorship visits at day 100 (n = 5) and at 1 year (n = 6) post stem cell transplant (SCT) and APP’s (n = 7) conducting the visits following an inter-rupted QI design Satisfaction scores were obtained from both parties using a modified version of the validated Short Assess-ment of Patient Satisfaction (SAPS) Scores of> 19 were con-sidered satisfying Additionally, 10-point Likert scales, binary, and open-ended questions were used to assess satisfaction, self-management, and survivorship care plan (SCP) utility We analyzed the data using descriptive statistics, reporting median scores and percentages for the most common results For open-ended questions, qualitative analysis was used to iden-tify themes
Results: We found patients were satisfied with the visit (median SAPS 25, range 19-28) Additionally, 100% were very satisfied with the effect of their care, found the SCP useful and reported improved post-visit self-efficacy Conversely, pro-viders were overall dissatisfied (median SAPS 14, range 6-19) Only 28% were satisfied with care they provided and 42% were dissatisfied with their plans We also found 42% of providers and 23% of patients were dissatisfied with explanations about post-SCT risks Furthermore, 29% of providers and 36% of patients were dissatisfied with care planning decisions Conclusion: Our APP-led survivorship model was satisfying for patients However, provider satisfaction was low Both parties expressed dissatisfaction with education about post-SCT risks and decisions affecting care planning Results of a theory based provider intervention to enhance satisfaction will be presented
at the 2019 Transplant and Cellular Therapies Meeting in Feb-ruary 2019
562 Cardiac and Vascular Events in Patients with History of Hematopoietic STEM CELL Transplant (HSCT) Are NOT Associated with Poor Outcomes: Analysis of National Inpatient Sample 2010-2014
Karan Jatwani MD1, Shraddha Jatwani MD2, Karan Chugh MD2.1Mount Sinai West - St Luke’s Hospital, New York, NY;2St Vincent Evansville, Evansville, IN
Background: Studies have suggested an increased risk of car-diovascular, cerebrovascular and peripheral vascular disease in patients with history of hematopoietic stem cell transplant (HSCT) (Tichelli et al, Blood 2007) This is attributed
Table 1
GO category enriched URTI GO category enriched in LRTI
Regulation of immune response Innate immune response in mucosa
Cell surface receptor
signaling pathway
Antibacterial humoral response Adaptive immune response Defense response to bacterium
Cellular defense response Response to drug
T cell activation Defense response to
gram-positive bacterium G-protein coupled receptor
signaling pathway
Defense response to fungus Nucleosome assembly
Figure 1 Differential gene expression in subjets with HRV URTI vs proven
LRTI (A) and HRV URTI vs possible LRTI (B) Distance from 0 along the x-axis
represents fold change expression in LRTI groups compared to URTI
(red = overexpression, green = underexpression) Distance from 0 along y-axis
represents level of signficance of differential expression.
Figure 2 Principle component analysis of top 500 most variable genes
dem-onstrates separation of subjects with HRV URTI and proven LRTI
Abstracts / Biol Blood Marrow Transplant 25 (2019) S290 S442 S373