About

Christopher Daugherty, MD, is a board certified medical oncologist, UChicago Medicine credentialed hematologist, and Professor of Medicine with over 20 years of experience in diagnosing, treating, and caring for patients with a wide spectrum of oncologic and hematologic disorders and malignant conditions. His research focuses on ethical issues involved in the care of cancer patients, and he is a national and international authority on doctor-patient communication, decision-making, end-of-life care, and informed consent as it relates to the care of cancer patients and their participation in clinical research. Dr. Daugherty has served as a local medical director for Vitas Hospice in Chicago and as the Chair of the Biological Sciences Division’s Institutional Review Board. He has received multiple awards and grants for his research from organizations including the American Society of Clinical Oncology, the American Society of Oncology, the Soros Foundation, and the National Institutes of Health.

Research topics

• Medicine
• Clinical psychology
• Psychology
• Psychiatry
• Political Science
• Internal medicine
• Nursing
• Social psychology
• Virology
• Oncology
• Physical therapy

Selected publications

• Financial Toxicity Has Never Been More Important in Cancer Care: How Do We Measure It?

  JCO Oncology Practice · 2025-01-01 · 6 citations

  editorialSenior author
  PublisherDOI

• Feasibility of Symptom Burden Assessments and Early Palliative Care Integration in an Adolescent and Young Adult Leukemia Clinic

  Journal of Adolescent and Young Adult Oncology · 2025-10-22

  article

  Adolescents and young adults (AYA; ages 15-39) with acute leukemia have significant unmet supportive care needs. This pilot study integrated same-day palliative care (PC) into an AYA leukemia clinic, measuring symptom burden (SB) with validated symptom assessment tools at baseline, 3, and 6 months. Among 31 patients, moderate-severe symptoms included tiredness, anxiety, and poor appetite. AYAs experienced high SB and psychological distress, regardless of care phase or sociodemographics. With PC integration, tiredness and depression improved significantly; no symptoms worsened. Half of the PC visits led to management changes. Early integration of symptom-focused PC was feasible, value-adding, and well-received by patients.

  PublisherDOI

• Spiritual wellness and quality-of-life in adult patients with newly diagnosed acute leukemia receiving initial therapy: Patient-reported outcomes (PROs) from a prospective observational study

  Blood · 2025-11-03

  articleOpen accessSenior author

  Abstract Introduction Acute leukemia (AL) is a life-threatening hematologic malignancy that often necessitates urgent hospitalization and rapid initiation of intensive, frequently toxic, therapies within hours to days of diagnosis. AL carries a markedly higher acuity than most cancers and presents with great variability in illness trajectories, treatment paradigms, and potentials for cure – even in the relapsed and refractory settings. The unique clinical dynamics of AL care often disrupt multiple domains of quality-of-life (QOL), including psychosocial, physical, emotional, and spiritual well-being. Patients with newly diagnosed AL are often confronted with multiple time-sensitive, complex decisions which can lead to profound spiritual distress as they navigate the emotional and existential impact of their illness. While increased spiritual wellness (SW) has been associated with improved physical functionality and QOL in patients with advanced cancers, particularly at the end-of-life, its role remains poorly understood in the distinct context of newly diagnosed AL. To address this gap, we conducted a prospective observational multi-methods study at the University of Chicago using patient-reported outcome measures (PROMs) to evaluate SW and QOL among adults with newly diagnosed AL receiving initial therapy. We evaluated early changes in PROMs and investigated the relationship between SW and QOL in this population. Methods Adult patients with newly diagnosed AL were prospectively enrolled and completed validated PROMs assessing SW (FACIT-Sp12) and QOL (FACT-Leu) within 7 days of AL diagnosis and again 30 days later. Five additional free-response questions exploring areas of spiritual practices, coping mechanisms, community support, and changes in outlook were asked at both time points and coded thematically using an open, double-coded approach. PROM changes over time were assessed via paired t-tests. The relationship between PROMs were assessed with Pearson correlation coefficients. Patients' SW scores were then stratified categorically into low, average, or high spirituality levels based on established national data (Munoz et al., Cancer, 2015). Chi-square tests examined associations between patients' spirituality levels and selected sociodemographic or biologic factors at both time points. Results Thirty patients were enrolled and completed all assessments. The median age was 52 years (range 21-93), 60% were female, and 53% had acute myeloid leukemia. All patients received disease-specific therapy during hospitalization. Qualitative analysis revealed 3 core themes: personal practice, community support, and perceived growth. Personal practices most commonly included prayer, meditation, and positive thinking. Community support ranged from spouses and family members to friends and religious/spiritual groups. Finally, 53% (16/30) reported a positive change in outlook, comfort, or hope between baseline and day 30. While the mean SW score did not significantly increase from enrollment to day 30 (36.5 vs 37.8, p = 0.31), QOL scores did significantly improve over the same period (111.3 vs 129, p = 0.022). SW had moderate, significant positive correlations with QOL at both enrollment (r = 0.47, p = 0.012) and day 30 (r = 0.43, p = 0.022). The distribution of patients' spirituality levels was 13.3% low, 76.7% average, and 10% high at enrollment; and 13.3%, 73.3%, and 13.3%, respectively, at day 30. Four patients (13%) demonstrated an increase in spirituality level between enrollment and day 30 (2 from low to average and 2 from average to high). Patients in the low spirituality level at enrollment were significantly more likely to have higher household income (50% with $100,000 or more, p = 0.044). No other sociodemographic or biologic factor differed significantly by spirituality level at either time point. Conclusions While SW is significantly correlated with QOL, only QOL significantly improved in the first 30 days following AL diagnosis and treatment initiation. This finding suggests that QOL in this population could improve further through a multidisciplinary care model that actively supports SW. During hospitalization for AL, many personal and community-based sources of encouragement, hope, and strength are often disrupted, which can contribute to spiritual distress. Integrating spiritual care into AL treatment paradigms has the potential to enhance patient-centered care and improve patient-reported outcomes.

  PublisherOA PDFDOI

• Financial Toxicity, Health-Related Quality of Life, and Medication Adherence Patient-Reported Outcomes (PROs) in Patients with Chronic Lymphocytic Leukemia (CLL) on First-Line Oral Oncolytics

  Blood · 2024-11-05 · 1 citations

  articleOpen access

  Introduction Oral oncolytic therapies (OOT) have transformed the treatment of CLL, but high costs may cause significant financial toxicity (FT) which can adversely impact patients (pts) beyond direct out of pocket costs. Associations of FT with health-related quality of life (HRQoL) and medication adherence is unknown for OOT in CLL. We performed a prospective, mixed methods longitudinal study of patient-reported outcomes (PROs) and semi-structured interviews in pts with CLL on first-line (1L) OOT. Methods Pts initiating 1L OOT for CLL at 2 academic centers received electronic PROs: FACIT-COST (significant FT <26), FACT-LEU for HRQoL, MARS-5 (suboptimal adherence <25) and PROMIS PMAS to assess medication adherence. PROs were administered at baseline, then at 3 and 6 months after enrollment. Pearson's (r) and Spearman's (⍴) correlations assessed relationships between PRO scores. Relationships between FT and baseline variables were analyzed by ANOVA. Semi-structured interviews were analyzed by rapid matrix methods. Results Forty-seven pts were enrolled: median age 66 years (range 33-86), 53% male, 9% Black, 6% Hispanic. Median time from 1L OOT initiation to enrollment: 29 days. Majority (51%) received BTK inhibitors, mostly acalabrutinib and zanubrutinib (43%); 53% received concurrent obinutuzumab. Most insurance coverage was Medicare (47%) or private insurance (45%). Majority had no copay (66%) and received grant or patient assistance program (PAP) support (57%). PRO completion rates were 100% (baseline), 85% (3 mo) and 83% (6 mo). Significant FT was observed in 22% (baseline), 33% (3 mo) and 28% (6 mo). Pts closer to their cancer center (r = 0.35, p = 0.048), Hispanic pts (p = 0.031), Black pts (p = 0.011), and unemployed (p = 0.032) pts had worse FT. Pts not receiving obinutuzumab had worse FT at 3 mos (p < .001). FT was strongly associated with inferior HRQoL at all timepoints (r = 0.64-0.58, p < 0.001) on all FACT-LEU domains. FT was associated with inferior medication adherence on PMAS at baseline (r = 0.31, p = 0.048), specifically the medication beliefs and knowledge domain (r = 0.30, p = 0.043). Suboptimal OOT adherence was observed in 34% (baseline), 39% (3 mo) and 48% (6 mo) on MARS-5. Nonadherence (MARS-5) was associated with inferior functional wellbeing at 6 mo (r = 0.40, p = 0.046). Nonadherence (PMAS) was associated with inferior social wellbeing at baseline (r = 0.38, p = 0.009) and 3 mo (r = 0.40, p = 0.02). Nonadherence measured by MARS-5 and PMAS were strongly correlated (r = 0.51, p < 0.001). Pts receiving obinutuzumab had better adherence on PMAS (r = 0.29, p = 0.048). There were no significant correlations with FT or adherence and having no copay or PAP support. The proportion of pts at least somewhat bothered by treatment side effects was 22% (baseline), 18% (3 mo) and 36% (6 mo). Overall side effect burden was not associated with FT or adherence. However, higher fatigue was associated with worse FT (⍴ = -0.29, p = 0.01). Multivariable analysis revealed that fatigue and full-time employment were associated with worse FT at 3 months (p = 0.015). Ten pts were interviewed. Most had no out of pocket costs aside from deductibles. Many reported uncertainty around future funding and/or losing access to PAP. OOT side effects included fatigue (most commonly), nausea, diarrhea, headaches, and weight loss. Many reported positive effects after starting OOT, including reduced lymphadenopathy and improved energy. All denied difficulty with OOT adherence, with a few reporting rare unintentionally missed doses. Discussion Pts with CLL on 1L OOT are at risk for early and progressive FT and suboptimal adherence that worsen over time. We found that FT and nonadherence are significantly associated with inferior HRQoL; assessment of these domains soon after OOT initiation is warranted to identify pts who may benefit from additional support. A significant proportion of pts reported FT and suboptimal adherence despite no copays and PAP support, suggesting these are driven by factors beyond out of pocket costs. Interview data suggest fear of losing future financial assistance may contribute to FT. Discrepancies between PRO and interview data surrounding adherence justify study of the MARS-5 and PROMIS PMAS instruments for OOT adherence assessment. Fatigue may also contribute to FT, specifically in employed pts, and future work should investigate how HRQoL and OOT-related side effects influence FT and medication adherence in CLL.

  PublisherOA PDFDOI

• Financial toxicity (FT), quality of life (QoL), and medication adherence patient-reported outcomes (PROs) in CLL on first-line (1L) oral oncolytics.

  Journal of Clinical Oncology · 2024-06-01

  article

  e23157 Background: While oral oncolytics have transformed CLL treatment, high costs may cause significant FT adversely impacting patients beyond direct out-of-pocket (OOP) costs. The association of FT with QoL and medication adherence has not been characterized with oral oncolytics in CLL. Methods: Electronic PRO surveys were longitudinally administered to patients initiating any 1L oral oncolytic therapy for CLL within the last 6 months at two academic centers. PROs included FACIT-COST (significant FT: score < 26), FACT-LEU QoL, MARS-5 (suboptimal adherence: score < 25) and PROMIS PMAS to assess medication adherence. PROs were administered at baseline, 3 months, and 6 months after enrollment. Pearson’s correlation ( r) was calculated between PRO domains. Semi-structured, qualitative interviews were conducted after 3-month timepoints and analyzed. Results: 34 patients were enrolled: median age 65 yrs (range 33-80), 59% male, 6% Black, 9% Hispanic. Majority received BTK inhibitors (56%, acalabrutinib/zanubrutinib) followed by venetoclax (44%); 50% received concurrent obinutuzumab. Most had private insurance (50%) followed by Medicare (44%). Median time from 1L initiation to study enrollment: 1.5 months. PRO completion rates: 100% (baseline), 85% (3 mo) and 74% (6 mo). Summarized PRO and interview outcomes are displayed below. Conclusions: Patients with CLL on 1L oral oncolytics experienced worsening FT associated with poor medication adherence and worse QoL over time. PROs were discordant with qualitative interviews and suggested that FT may be driven by factors other than OOP costs. Although funding and patient assistance programs were beneficial, uncertainty over losing funding may be a long-term driver of FT and merits further study. [Table: see text]

  PublisherDOI

• Clinical and molecular response of acute myeloid leukemia harboring non-canonical <i>FLT3</i> N676K driver mutations to contemporary FLT3 inhibitors

  Haematologica · 2023-01-19 · 3 citations

  letterOpen access

  Not available.

  PublisherOA PDFDOI

• Impact of death anxiety (DA) on the psychological well-being and survival of patients with advanced cancer (ACP) in phase I trials and their spousal caregivers (SC).

  Journal of Clinical Oncology · 2023-06-01

  articleSenior author

  e24213 Background: ACP and their SC experience psychological distress living with future uncertainty regarding their cancer. Yet, little is known how existential DA adversely impacts the psychological well-being and overall survival of ACP participating in Phase I trials and their SC. Methods: A prospective study of ACP enrolling in phase I trials and their SC were assessed at baseline (T1) and one month (T2) using quantitative symptom measures including: depression (CES-D), state anxiety (STAI-S), quality of life/qol (FACIT-Pal), and global health (SF-36). Semi-structured interviews evaluated DA: suffering; meaning, and worry re death. Results: To date, 158 participants (79 Phase I ACP and 79 SC) have been separately interviewed at T1 and T2. For the total population: median age 62 (28-79y); 50% male; 100% married; 89% Ca; 69% > HS educ; 59% GI dx; ACP median survival 8.2 month (.51-18.8) 53% income < $65,000 yr. At T1, 83% of ACP experienced worry re death, and 77% reported suffering. For SC at T1, 75% reported worry re ACP death; 88% worried re own death; and 85% reported experiencing suffering and 84% lost meaning during the ACP illness. For both ACP and SC, rates remained consistent for both ACP and SC. At T2, ACP with worry re death had higher STAI-S (32±11 v. 28±9, p = 0.04) and CES-D scores (12±10 v. 11±10, p = 0.03). SC with self-reported suffering had higher STAI-S anxiety (38±15 v. 34±12, p = 0.02) at T2. Regression analyses revealed ACP with worry had worsening FACIT-Pal QOL over time. Also, SC with suffering at T2 was negatively associated with SF-36 scores. Regarding survival, ACP with DA had shorter survival compared to ACP without DA (4.4 v. 6.9 months, p = 0.02). Conclusions: Phase I ACP and SC report worry re death and suffering negatively impacting their psychological well-being and survival. Supportive couple-based, dyadic psychological interventions for ACP-SC designed to address DA coping are needed.

  PublisherDOI

• Symptom burdens in long-term survivors of gynecologic cancer receiving acupuncture care.

  Journal of Clinical Oncology · 2023-06-01

  article1st authorCorresponding

  e24152 Background: Gynecologic cancer survivors (GCS) experience physical and emotional symptom burdens (SB) due to advanced, recurrent disease and intensive treatment often requiring supportive, complementary/integrative therapies. Yet, limited evidence exists on which specific SB require attention and intervention. This study aimed to identify demographics and SB of GCS referred for outpatient acupuncture services at a U.S. cancer center. Methods: A retrospective analysis was conducted of GCS actively receiving outpatient acupuncture services at the University of Chicago Supportive Oncology Program between March 2021 and June 2022. A brief self-reported SB assessment using a 0-10 Likert rating scale was completed at each acupuncture treatment. Socio-demographic (age, religion), disease information (stage) and SB (pain, insomnia) information was obtained from the medical record. Descriptive statistics were analyzed and paired sample t-tests evaluated SB differences prior to first and final treatment. Results: Eighty-three percent (54 of 65 referred) GCS received outpatient acupuncture care. Seventeen percent (11 of 65 referred) were unable to seek acupuncture due to disease progression leading to referral for end-of-life care (e.g. hospice, home palliative care). The mean age of GCS receiving acupuncture was 60y (range 30-81); 97% Non Hispanic, 65% White; 32% African American; 58% married; 53% with children; 65% Christian; 59% retired/on disability. Fifty percent of GCS had endometrial dx, 47% ovarian; 95% Stage IV; mean 7y since dx (range = .6-20y); 88% lacked advanced directives (e.g. DNR). Seventy percent completed at least four weekly acupuncture treatments. Prevalent SB were fatigue (94.1%), sleep disturbance (88.3%), pain (88.2%), anxiety (82.6%); and neuropathy (52.9%). On average, elevated SB mean scores were fatigue, numbness, anxiety, and hot flashes. Neuropathy was scored as the most severe (≥8 of 10). No significant improvement in SB was identified at the third treatment (p = 0.10). At the sixth session, GCS reported significantly less pain (p = 0.02). SB change was both statistically and clinically significant in 61-73% GCS at last session, except nausea. Only 0-5% of GCS reported worsening SB after acupuncture. Conclusions: Our results suggest acupuncture may aid in GCS SB control serving as a useful adjunct during cancer treatment and beyond. Early acupuncture referral may benefit GCS coping with SB during the cancer trajectory and is warranted. Future research should use a longitudinal prospective cohort design with validated SB measures.

  PublisherDOI

• Socioeconomic Determinants and the Biology and Outcomes of Acute Lymphoblastic Leukemia in Adults

  Blood · 2023-11-02

  articleOpen access

  Introduction Implementation of pediatric-inspired chemotherapy regimens improved survival outcomes in adolescents and young adults (AYA) with acute lymphoblastic leukemia (ALL). Prior studies demonstrated that Non-Hispanic White (NHW) patients had better survival outcomes in the real-world AYA setting, but this effect was not observed in the pivotal CALGB 10403 clinical trial. To better characterize the socioeconomic versus biologic determinants of ALL outcomes, we conducted a single-institution, retrospective analysis of adult patients with ALL at the University of Chicago. We sought to investigate the impact of socioeconomic factors on ALL outcomes when patients are treated at a multidisciplinary, tertiary-care ALL center. Methods Adult patients with ALL treated at the University of Chicago between 2010 and 2022 were studied. Subtype classification was based on the 2022 WHO criteria. ALL patients were treated according to age-appropriate regimens (AYA with CALGB 10403-based regimens, older adults (>40) with lower intensity approaches). Because of treatment differences, outcomes of AYA and older patients were analyzed separately. Self-reported race was reported with guidelines from the National Cancer Institute (https://www.nih.gov/nih-style-guide/race-national-origin). Body mass index (BMI) was recorded at diagnosis. Annual median income was estimated based on the zip code of residence and categorized as high (>$50,000), middle ($35,000-50,000), and low (<$35,000). Additionally, we extracted data from the public use US population-based cancer registries of the Surveillance, Epidemiology, and End Results (SEER, http://seer.cancer.gov) program to estimate overall survival (OS) of ALL patients diagnosed between 2005 and 2020. Results Demographic and disease characteristics of 221 adult ALL patients treated at the University of Chicago are summarized in Table 1. BCR::ABL1 was more prevalent in Black ALL patients compared to NHW and Hispanic White (HW) patients (59% vs 24% and 20%, respectively, p=0.001). This phenotypic subtype was also associated with higher BMI (OR 7.64; 95% CI=1.17-49.9, p=0.03). Compared to NHW patients, low annual household income was more frequent in HW and Black patients (2% vs 13% and 24%, respectively, p<0.001). Similar OS was seen among NHW, HW, and Black patients when stratified by age (AYA vs older adult), B vs T-lineage phenotype, or median household income. Obesity at B-ALL diagnosis was associated with adverse OS, and median OS for patients with BMI <30, 30-40, and >40 were 113 months, 34 months (HR 2.04; 95% CI=1.27-3.28, p=0.003), and 23 months (HR 2.70; 95% CI=1.34-5.42, p=0.005), respectively. In our multivariable analysis, factors that were independently associated with adverse OS were age and BMI at diagnosis (HR 6.93; 95% CI 2.27-21.1, p=0.0007; HR 10.3; 95% CI 2.56-41.5, p=0.001, respectively), while BCR::ABL1 positivity predicted favorable OS (HR 0.41; 95% CI 0.2-0.87, p=0.02, see Figure 1). Compared to the SEER cohort, OS in older University of Chicago patients was better than the national average (53 months vs 23 months, HR 0.70; 95% CI=0.56-0.88, p=0.003). Among SEER AYA patients from 2015-2020, HW (HR 1.54; 95% CI=1.26-1.91, p=<0.001) and Black (HR 1.64; 95% CI=1.14-2.36, p=0.006) patients had significantly worse OS compared to NHW patients. Finally, SEER data showed that patients with higher median household incomes had better OS than patients with lower incomes. Specifically, older adult patients who reported higher median household income had better OS at 24 months compared to older adults with medium or low income at 15 months (respectively, HR 1.25; 95% CI=1.10-1.47, p=<0.001; HR 1.52; 95% CI=1.07-2.17, p=0.01). Conclusion While SEER data demonstrated significant OS differences based on race and median household income nation-wide, these variables did not predict adverse OS at our institution. The University of Chicago has an ALL center with a dedicated AYA clinic offering resources to support patients throughout their long pediatric-inspired therapies, as well as clinical trial options for both young and older adults. Located in a historically Black and low-income neighborhood, the University of Chicago plays a critical role in addressing socioeconomic disparities in ALL care for our community. Further interventional studies are needed to modify the poor prognostic impact of obesity in patients with ALL.

  PublisherOA PDFDOI

• Identifying trends for high symptom burden across the care continuum in adolescents and young adults (AYA) with hematologic malignancies.

  Journal of Clinical Oncology · 2022-06-01

  articleSenior author

  10019 Background: Cancer in adolescence and young adulthood is a non-normative life event associated with profound long-term physical and psychosocial consequences. Prior studies specifically demonstrate AYA patients with hematologic malignancies experience high symptom burden with poor quality of life. Here, we describe trends and factors associated with high symptom burden in patients treated at a multi-disciplinary AYA leukemia clinic at an academic medical center. Methods: The Edmonton Symptom Assessment Scale [ESAS] (measuring physical symptoms) and Brief Symptom Inventory-18 [BSI-18] (measuring psychological distress) were administered at baseline, 3 months, and 6 months from initial survey. Baseline demographic and treatment characteristics were collected. All patients had leukemia or lymphoma, were on treatment or in survivorship, and had access to a palliative care provider who was integrated into the clinic. Data was analyzed using Wilcox ranked sum test and linear mixed-effects model testing. Results: Of the 31 patients (median age 29 years, range 18-43) who completed surveys, 25 (80%) completed surveys at 6 months; 48% were female, 58% were white, 16% lived alone, 28% were single, 37% had children, 54% completed college, and 35% had an annual household income ≥ $75,000. Phases of care included 52% on intensive frontline/salvage treatment, 19% in maintenance (i.e. lower intensity) therapy, 16% as recent stem cell transplant (SCT) recipients (< 1 year since date of transplant), and 13% in survivorship. Overall, ESAS scores among patients were similar regardless of care phases; however, patients on frontline/salvage therapy reported higher fatigue than those in maintenance (p = 0.01). Moderate-severe symptoms (defined as ESAS > 3), including tiredness, anxiety, poor appetite, and poor feeling of well-being, were reported regardless of phase of care. At 6 months, there was no significant change in BSI-18 scores compared to baseline, while tiredness (p = 0.02), depression (p = 0.01), and constipation (p = 0.02) improved; no ESAS scores worsened. Age ≥ 30 was associated with worsening anxiety (p = 0.01) at 6 months vs baseline, while no statistically significant differences in ESAS scores were observed among race, education, relationship status, presence of children, living arrangement, or income. Conclusions: AYA patients with hematologic malignancies experience high symptom burden independent of demographic characteristics or phase of care. These findings highlight the need for standard symptom screening at each visit and the importance of incorporating supportive care throughout the continuum.

  PublisherDOI

Recent grants

• NIH Grant R01CA087605

  NIH · $2.0M · 2012

Frequent coauthors

• Fay J. Hlubocky

  University of Chicago

  177 shared

• Mark J. Ratain

  University of Chicago

  56 shared

• Kristen Wroblewski

  Chicago Department of Public Health

  54 shared

• Mark Siegler

  University of Chicago

  44 shared

• Andrew Hantel

  Dana-Farber Cancer Institute

  41 shared

• Trinh T. Nguyen

  The University of Texas MD Anderson Cancer Center

  36 shared

• Samantha Bastow

  Becton Dickinson (United States)

  36 shared

• Erin S. DeMartino

  Mayo Clinic

  36 shared

Awards & honors

• American Society of Clinical Oncology research award
• American Society of Oncology research award
• Soros Foundation research grant
• National Institutes of Health research grant