Abstract
Myeloablative hematopoietic cell transplantation (HCT) is a common treatment for hematological malignancy. Delayed immune reconstitution following HCT is a major impediment to recovery with patients being most vulnerable during the first month after transplant. HCT is a highly stressful process. Because psychological distress has been associated with down regulation of immune function we examined the effect of pre-transplant distress on white blood cell (WBC) count among 70 adult autologous HCT patients during the first 3. weeks after transplant. The participants were on average 38. years old; 93% Caucasian, non-Hispanic and 55% male. Pre-transplant distress was measured 2-14. days before admission using the Cancer and Treatment Distress (CTXD) scale, and the Symptom Checklist-90-R (SCL-90-R) anxiety and depression subscales. WBC count was measured during initial immune recovery on days 5 through 22 post-transplant. Linear mixed model regression analyses controlling for gender and treatment-related variables revealed a significant effect of the mean pre-transplant SCL Anxiety-Depression score on WBC recovery. We found no significant effect of pre-transplant CTXD on WBC recovery. In general, higher levels of pre-treatment anxiety and depression were associated with slower WBC recovery. Psychological modulation of WBC recovery during HCT suggests a unique mechanism by which psychological distress can exert influence over the immune system. Given that WBC recovery is essential to survival for HCT patients, these data provide a rationale for treating anxiety and depression in HCT patients.
Original language | English (US) |
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Pages (from-to) | S142-S148 |
Journal | Brain, Behavior, and Immunity |
Volume | 30 |
Issue number | SUPPL. |
DOIs | |
State | Published - Mar 15 2013 |
Externally published | Yes |
Keywords
- Anxiety
- Cancer
- Cancer treatment-related distress
- Depression
- Hematologic malignancy
- Hematopoietic cell transplantation
- Immune reconstitution
ASJC Scopus subject areas
- Immunology
- Endocrine and Autonomic Systems
- Behavioral Neuroscience