The effect of pre-transplant distress on immune reconstitution among adult autologous hematopoietic cell transplantation patients

Bonnie A. McGregor, Karen L. Syrjala, Emily D. Dolan, Shelby L. Langer, Mary Redman

Research output: Contribution to journalArticle

21 Scopus citations

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 languageEnglish (US)
Pages (from-to)S142-S148
JournalBrain, Behavior, and Immunity
Volume30
Issue numberSUPPL.
DOIs
StatePublished - Mar 15 2013
Externally publishedYes

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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

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