Pre-transplant emotional support is associated with longer survival after allogeneic hematopoietic stem cell transplantation.
Pre-transplant emotional support is associated with longer survival after allogeneic hematopoietic stem cell transplantation.
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DOI：
10.1038/bmt.2016.191
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发表时间：
2016-12
影响因子：
4.8
通讯作者：
Penedo, F. J.
中科院分区：
文献类型：
--
作者：
Ehrlich, K. B.;Miller, G. E.;Scheide, T.;Baveja, S.;Weiland, R.;Galvin, J.;Mehta, J.;Penedo, F. J.
Emerging evidence suggests that psychosocial factors pre-transplant predict survival in cancer patients undergoing hematopoietic stem cell transplantation (HSCT). These studies, however, typically have small sample sizes, short-term follow-ups, or a limited panel of medical covariates. We extend this research in a large, well-characterized sample of transplant patients, asking whether patients’ perceived emotional support and psychological distress predict mortality over two years. Prior to transplant, 400 cancer patients (55.5% males; 82.8% White; Mage = 50.0yrs; 67.0% leukemia, 20.0% lymphoma) were interviewed by a social caseworker, who documented the patients’ perceived emotional support and psychological distress. Subsequently, patients received an allogeneic HSCT (51.0% matched related donor, 42.0% matched unrelated donor, and 7.0% cord blood). HSCT outcomes were obtained from medical records. Controlling for demographic characteristics (age, sex, race/ethnicity, marital status) and medical confounders (disease type, conditioning regimen, remission status, cell dosage, donor and recipient CMV seropositivity, donor sex, comorbidities, and disease risk), ratings of good emotional support pre-transplant predicted longer overall survival (hazard ratio = .61, 95% CI, .42 – .91; p = .013). Pre-transplant psychological distress was unrelated to survival, however (ps > .58). Emotional support was marginally associated with lower rates of treatment-related mortality (HR = .58, CI, .32 – 1.05; p = .073). These findings are consistent with the hypothesis that emotional support contributes to better outcomes following HSCT. Future studies should examine whether intervention efforts to optimize emotional resources can improve survival in cancer patients.
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