Post-Traumatic Stress Symptoms in Hematopoietic Stem Cell Transplant Recipients

Fenech, Alyssa L.; Benschoten, Olivia Van; Jagielo, Annemarie D.; Ufere, Nneka N.; Topping, Carlisle E.W.; Clay, Madison A.; Jones, Bailey; Traeger, Lara; Temel, Jennifer S.; El‐Jawahri, Areej

doi:10.1016/j.jtct.2021.01.011

Cited by 22 publications

(23 citation statements)

References 32 publications

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“…The mean FACT-BMT score in the autologous cohort was 142.55 ± 25 The mean BDI scores in the autologous and allogeneic cohorts were 8.96 ± 5.50 and 11.05 ± 8.22, respectively, and the mean SSTAI scores were 80.72 ± 18.25 and 81.96 ± 21.24, respectively. The mean scores on the SSTAI Trait and State subscales were 41.11 ± 8.55 and 39.79 ± 11.24, respectively, for the autologous cohort and 42.76 ± 10.78 and 39.54 ± 12.00, respectively, for the allogeneic cohort.…”

Section: Resultsmentioning

confidence: 97%

“…Interest in the relationship between clinically relevant depressive and anxiety symptoms and QOL is growing 24 . The most explored psychiatric conditions are major depressive disorder, generalized anxiety disorder, obsessive-compulsive disorder, and post-traumatic stress disorder [25][26][27] . Affective symptoms interfere with treatment adherence, adversely affect survival, and decrease patients' perceptions of QOL 9,20 .…”

Section: Impact Of the Type Of Hematopoietic Stem-cell Transplant On ...mentioning

confidence: 99%

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Impact of the type of hematopoietic stem-cell transplant on quality of life and psychopathology

Janicsák¹,

Reményi²,

Ungvari³

et al. 2023

Ideggyógyászati szemle

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Background and purpose – Despite the decrease in transplant-related mortality, patients who receive hematopoietic stemcell transplants often suffer from short-and long-term morbidities, poorer quality of life, and psychosocial functioning deficits. Several studies have compared the quality of life and affective symptoms of patients after undergoing autologous and allogeneic hematopoietic stem-cell transplants. Some studies have reported similar or greater quality of life impairments in allogeneic hematopoietic stemcell recipients, but the findings have been inconsistent. Our purpose was to examine the influence of the type of hematopoietic stem-cell transplantation on the quality of life and affective symptoms of patients. Methods – The study sample comprised 121 patients with various hematological diseases who underwent hematopoietic stem-cell transplantation at St. István and St. László Hospitals, Budapest. The study had a cross-sectional design. Quality of life was evaluated using the Hungarian version of the Functional Assessment of Cancer Therapy– Bone Marrow Transplant scale (FACT-BMT). Anxiety and depressive symptoms were assessed using Spielberger’s State and Trait Anxiety Inventory (STAI) and the Beck Depression Inventory (BDI), respectively. Basic sociodemographic and clinical variables were also recorded. Comparisons between autologous and allogeneic recipients were analyzed using a t-test when the variables were normally distributed and a Mann–Whitney U test otherwise. A stepwise multiple linear regression analysis was performed to identify the risk factors that contributed to the quality of life and the affective symptoms in each group. Results – Quality of life (p=0.83) and affective symptoms (pBDI=0.24; pSSTAI=0.63) were similar between the autologous and allogeneic transplant groups. The BDI scores of allogeneic transplant patients indicated mild depression, but their STAI scores were similar to those of the general population. Allogeneic transplant patients with symptoms of graft-versus-host disease (GVHD) experienced more severe clinical conditions (p=0.01), poorer functional status (p<0.01) and received more immunosuppressive treatment (p<0.01) than those without graft versus host disease. Patients suffering from graft versus host disease experienced more severe depression (p=0.01), and constant anxiety (p=0.03) than those without graft versus host disease. Quality of life was affected by depressive and anxiety symptoms and psychiatric comorbidity in both the allogeneic and autologous groups. Conclusion – Graft versus host disease-related severe somatic complaints seemed to influence the allogeneic transplant patients’ quality of life by inducing depressive and anxiety symptoms.

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Section: Resultsmentioning

confidence: 97%

Section: Impact Of the Type Of Hematopoietic Stem-cell Transplant On ...mentioning

confidence: 99%

Impact of the type of hematopoietic stem-cell transplant on quality of life and psychopathology

Janicsák¹,

Reményi²,

Ungvari³

et al. 2023

Ideggyógyászati szemle

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“…Physical symptoms are common and sometimes debilitating, perhaps comparable to patients with acute leukemias undergoing intensive high-dose chemotherapies. Psychologically, patients who undergo HSCT are highly likely to develop post-traumatic stress symptoms due to their treatment experience [60,84,111,112]. The prolonged, socially isolating hospitalizations are associated with decreased patient-reported QOL, elevated levels of anxiety, and depressive symptoms including pronounced anhedonia [113].…”

Section: Symptom Burden and Palliative Care Needsmentioning

confidence: 99%

Advancing Palliative Care Integration in Hematology: Building Upon Existing Evidence

Robbins-Welty

Webb

Shalev

et al. 2023

Curr. Treat. Options in Oncol.

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Patients with hematologic malignancies and their families are among the most distressed of all those with cancer. Despite high palliative care-related needs, the integration of palliative care in hematology is underdeveloped. The evidence is clear that the way forward Current Treatment Options in Oncology includes standard-of-care PC integration into routine hematologic malignancy care to improve patient and caregiver outcomes. As the PC needs for patients with blood cancer vary significantly by disease, a disease-specific PC integration strategy is needed, allowing for serious illness care interventions to be individualized to the specific needs of each patient and situation.

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“…[4][5][6][7][8][9][10][11][12] Thus, patients referred for CAR T-cell therapy face substantial uncertainties about their future that may cause significant psychological distress and exacerbate underlying symptoms of posttraumatic stress disorder (PTSD). [13][14][15] To understand how to best support these patients with the uncertainties of CAR T-cell therapy, a detailed evaluation into patients' perception of their prognosis and its relationship with patient's quality of life (QOL) and psychological distress is needed.…”

Section: Introductionmentioning

confidence: 99%

“…Furthermore, nearly half of all patients receiving CAR T‐cell therapy experience disease progression, resulting in intense health care utilization and rapid decline near the end of life (EOL) 4–12 . Thus, patients referred for CAR T‐cell therapy face substantial uncertainties about their future that may cause significant psychological distress and exacerbate underlying symptoms of posttraumatic stress disorder (PTSD) 13–15 . To understand how to best support these patients with the uncertainties of CAR T‐cell therapy, a detailed evaluation into patients' perception of their prognosis and its relationship with patient's quality of life (QOL) and psychological distress is needed.…”

Section: Introductionmentioning

confidence: 99%

Perception of prognosis, quality of life, and distress in patients receiving chimeric antigen receptor T‐cell therapy

Dhawale

Johnson

Gaballa

et al. 2022

Cancer

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Background Chimeric antigen receptor (CAR) T‐cell is potentially curative therapy for patients with hematologic malignancies but can cause life‐threatening toxicities. Data on perceptions of prognosis and psychological distress are lacking. Methods The authors conducted a cross‐sectional study of patients receiving CAR‐T. Before hospitalization for CAR‐T, patients completed assessments of quality of life (QOL) (Functional Assessment of Cancer Therapy‐General), anxiety and depression symptoms (Hospital Anxiety and Depression Scale) and post‐traumatic stress disorder symptoms (Post‐Traumatic Stress Checklist). Patients also completed the Prognostic Awareness Impact Scale (PAIS), which measures three domains: cognitive understanding of prognosis, emotional coping with prognosis, and adaptive response. Results A total of 71.8% (102 of 142) of eligible patients were enrolled. A total of 34% of patients reported that their oncologist said their cancer is curable and 64% reported there was >50% chance of cure. Overall, 26%, 30%, and 21% of patients reported clinically significant depression, anxiety, and posttraumatic stress disorder (PTSD) symptoms, respectively. We found no association between patients' cognitive understanding of prognosis and QOL or mood. Higher emotional coping with prognosis was associated with better QOL (Β = 0.72; SE = 0.10; p = <.001) and lower depression (Β = −0.17; SE = 0.02; p = <.001), anxiety (Β = −0.21; SE = 0.02; p = <.001), and PTSD (Β = −0.43; SE = 0.06; p = <.001) symptoms. Higher adaptive response was associated with better QOL (Β = 0.19; SE = 0.09; p = .028) and lower depression (Β = −0.05; SE = 0.02; p = .023), anxiety (Β = −0.09; SE = 0.02; p = <.001), and PTSD (Β = −0.19; SE = 0.05; p = <.001) symptoms. Conclusions Patients undergoing CAR‐T report overly optimistic perception of their prognosis and have high rates of psychological distress. Higher emotional coping with prognosis and adaptive response were associated with better QOL and less psychological distress, underscoring the need to develop interventions to promote coping with this treatment. Plain language summary Patients undergoing chimeric antigen receptor T‐cell therapy experience report overly optimistic perceptions of their prognosis and have high rates of psychological distress. Notably, higher emotional coping with prognosis and adaptive response were associated with better quality of life and less psychological distress.

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Post-Traumatic Stress Symptoms in Hematopoietic Stem Cell Transplant Recipients

Cited by 22 publications

References 32 publications

Impact of the type of hematopoietic stem-cell transplant on quality of life and psychopathology

Impact of the type of hematopoietic stem-cell transplant on quality of life and psychopathology

Advancing Palliative Care Integration in Hematology: Building Upon Existing Evidence

Perception of prognosis, quality of life, and distress in patients receiving chimeric antigen receptor T‐cell therapy

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