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Ames SC, Lange L, Ames GE, Heckman MG, White LJ, Roy V, Foran JM. A prospective study of the relationship between illness perception, depression, anxiety, and quality of life in hematopoietic stem cell transplant patients. Cancer Med 2024; 13:e6906. [PMID: 38205943 PMCID: PMC10905249 DOI: 10.1002/cam4.6906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 12/13/2023] [Accepted: 12/21/2023] [Indexed: 01/12/2024] Open
Abstract
AIM The aim of study was to investigate whether depression and anxiety symptoms and illness perception prior to hematopoietic stem cell transplantation (HSCT) predict health related quality of life (HRQOL) at Day 100 and 1 year following HSCT. METHODS A total of 205 patients who underwent HSCT (N = 127 autologous transplants, N = 78 allogeneic transplants) were included in this prospective study. Baseline assessment was assessed prior to transplantation and post HSCT data were collected at Day 100 and 1 year. At baseline we assessed depressive symptoms (Patient Health Questionnaire-9), anxiety symptoms (Generalized Anxiety Disorder-7), illness perception (Brief Illness Perception Questionnaire), and HRQOL (Functional Assessment of Cancer Therapy-BMT). RESULTS Patients who expressed a greater level of concern about the severity, course, and ability to exert control over one's illness (i.e., illness perception) and who reported a greater level of depression and anxiety symptoms prior to HSCT reported lower HRQOL at both Day 100 and 1 year posttransplant, with a similar degree of association observed at the two follow-up time points. CONCLUSIONS Our findings suggest that pretransplant perceptions about their illness and negative mood are significant predictors of HRQOL following HSCT. Illness perception, depression, and anxiety are potentially modifiable risk factors for less than optimal outcome after HCSCT and intervention strategies should be explored.
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Affiliation(s)
- Steven C. Ames
- Division of Hematology and OncologyMayo Clinic FloridaJacksonvilleFloridaUSA
| | - Lori Lange
- Department of PsychologyUniversity of North FloridaJacksonvilleFloridaUSA
| | - Gretchen E. Ames
- Department of Psychiatry and PsychologyMayo Clinic FloridaJacksonvilleFloridaUSA
| | - Michael G. Heckman
- Division of Clinical Trials and BiostatisticsMayo Clinic FloridaJacksonvilleFloridaUSA
| | - Launia J. White
- Division of Clinical Trials and BiostatisticsMayo Clinic FloridaJacksonvilleFloridaUSA
| | - Vivek Roy
- Division of Hematology and OncologyMayo Clinic FloridaJacksonvilleFloridaUSA
| | - James M. Foran
- Division of Hematology and OncologyMayo Clinic FloridaJacksonvilleFloridaUSA
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Lange LJ, Ames SC, Ames GE, Heckman MG, White LJ, Roy V, Foran JM. Loneliness, immunological recovery patterns, and health-related quality of life (HRQOL) outcomes in patients receiving hematopoietic stem cell transplantation. BMC Psychol 2024; 12:40. [PMID: 38243338 PMCID: PMC10797957 DOI: 10.1186/s40359-024-01535-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 01/11/2024] [Indexed: 01/21/2024] Open
Abstract
PURPOSE Loneliness may compromise health-related quality of life (HRQOL) outcomes and the immunological impacts of loneliness via neuroendocrinological mechanisms likely have consequences for patients who have undergone a hematopoietic stem cell transplantation (HSCT). RESEARCH APPROACH AND MEASURES Loneliness (pre-transplant), immunological recovery (Day 30, Day 100, 1-year post-transplant), and HRQOL (Day 100, 1 year) were measured in a sample of 205 patients completing a HSCT (127 autologous, 78 allogenic). RESULTS Greater levels of pre-transplant loneliness predicted poorer HRQOL at Day 100 and 1-year follow-up. Loneliness also was associated with higher absolute neutrophil to absolute lymphocyte (ANC/ALC) ratios in the entire sample at Day 30, which in turn was associated with Day 100 HRQOL. CONCLUSIONS Findings demonstrate that pretransplant loneliness predicts HRQOL outcomes and associates with inflammatory immunological recovery patterns in HSCT patients. The balance of innate neutrophils to adaptive lymphocytes at Day 30 present a distinct profile in lonely individuals, with this immunity recovery profile predicting reduced HRQOL 100 days after the transplant. Addressing perceptions of loneliness before HSCT may be an important factor in improving immunological recovery and HRQOL outcomes.
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Affiliation(s)
- Lori J Lange
- Department of Psychology, University of North Florida, 1 UNF Drive, 32224, Jacksonville, FL, USA.
| | - Steven C Ames
- Division of Hematology and Oncology, Mayo Clinic Florida, 4500 San Pablo Road South, 32224, Jacksonville, FL, USA
| | - Gretchen E Ames
- Department of Surgery, Mayo Clinic Florida, 4500 San Pablo Road South, 32224, Jacksonville, FL, USA
| | - Michael G Heckman
- Division of Clinical Trials and Biostatistics, Mayo Clinic Florida, 4500 San Pablo Road South, 32224, Jacksonville, FL, USA
| | - Launia J White
- Division of Clinical Trials and Biostatistics, Mayo Clinic Florida, 4500 San Pablo Road South, 32224, Jacksonville, FL, USA
| | - Vivek Roy
- Division of Hematology and Oncology, Mayo Clinic Florida, 4500 San Pablo Road South, 32224, Jacksonville, FL, USA
| | - James M Foran
- Division of Hematology and Oncology, Mayo Clinic Florida, 4500 San Pablo Road South, 32224, Jacksonville, FL, USA
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Malard F, Holler E, Sandmaier BM, Huang H, Mohty M. Acute graft-versus-host disease. Nat Rev Dis Primers 2023; 9:27. [PMID: 37291149 DOI: 10.1038/s41572-023-00438-1] [Citation(s) in RCA: 30] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/02/2023] [Indexed: 06/10/2023]
Abstract
Acute graft-versus-host disease (GVHD) is a common immune complication that can occur after allogeneic haematopoietic cell transplantation (alloHCT). Acute GVHD is a major health problem in these patients, and is associated with high morbidity and mortality. Acute GVHD is caused by the recognition and the destruction of the recipient tissues and organs by the donor immune effector cells. This condition usually occurs within the first 3 months after alloHCT, but later onset is possible. Targeted organs include the skin, the lower and upper gastrointestinal tract and the liver. Diagnosis is mainly based on clinical examination, and complementary examinations are performed to exclude differential diagnoses. Preventive treatment for acute GVHD is administered to all patients who receive alloHCT, although it is not always effective. Steroids are used for first-line treatment, and the Janus kinase 2 (JAK2) inhibitor ruxolitinib is second-line treatment. No validated treatments are available for acute GVHD that is refractory to steroids and ruxolitinib, and therefore it remains an unmet medical need.
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Affiliation(s)
- Florent Malard
- Sorbonne Université, Centre de Recherche Saint-Antoine INSERM UMRs938, Service d'Hématologie Clinique et de Thérapie Cellulaire, Hôpital Saint Antoine, AP-HP, Paris, France.
| | - Ernst Holler
- University Hospital of Regensburg, Department of Internal Medicine 3, Regensburg, Germany
| | - Brenda M Sandmaier
- Fred Hutchinson Cancer Center, Translational Science and Therapeutics Division, Seattle, WA, USA
- University of Washington School of Medicine, Division of Medical Oncology, Seattle, WA, USA
| | - He Huang
- Bone Marrow Transplantation Center, The First Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang Province, Hangzhou, China
- Engineering Laboratory for Stem Cell and Immunity Therapy, Institute of Hematology, Zhejiang University, Hangzhou, China
- Zhejiang Laboratory for Systems & Precision Medicine, Zhejiang University Medical Center, Hangzhou, China
| | - Mohamad Mohty
- Sorbonne Université, Centre de Recherche Saint-Antoine INSERM UMRs938, Service d'Hématologie Clinique et de Thérapie Cellulaire, Hôpital Saint Antoine, AP-HP, Paris, France.
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Hansen JL, Juckett MB, Foster MA, Rumble ME, Morris KE, Hematti P, Costanzo ES. Psychological and physical function in allogeneic hematopoietic cell transplant survivors with chronic graft-versus-host disease. J Cancer Surviv 2023; 17:646-656. [PMID: 36917433 PMCID: PMC10246467 DOI: 10.1007/s11764-023-01354-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 02/26/2023] [Indexed: 03/16/2023]
Abstract
PURPOSE Chronic graft-versus-host disease (cGVHD) is a common late complication of allogeneic hematopoietic cell transplantation (HCT). This study comprehensively evaluated physical and psychological function among individuals with cGVHD. Additional aims were to investigate relationships between disease severity and psychological and physical function, and to investigate patterns of psychological and physical function by disease site. METHOD Adults at least 6 months post allogeneic HCT were enrolled and either had cGVHD (n =59) or served as a reference sample of HCT survivors with no cGVHD history (n = 19). Participants completed self-report measures of depression, anxiety, fatigue, insomnia, pain, cognition, and sexual function and had a comprehensive clinical evaluation of cGVHD using NIH consensus scoring criteria. Participants with cGVHD were stratified by disease severity and site and compared to the reference group with no cGVHD. RESULTS Participants with mild cGVHD had comparable psychological and physical symptoms to the reference sample, while participants with moderate cGVHD experienced more severe anxiety and problems with sexual function, and participants with severe cGVHD experienced more severe depressive symptoms and pain compared to the reference sample. Participants with cGVHD manifesting in the skin and GI tract had the most severe symptoms, including mood disturbance, fatigue, and pain. CONCLUSIONS AND IMPLICATIONS FOR CANCER SURVIVORS Results suggest that patients with more severe cGVHD and those with cGVHD manifesting in the skin, GI tract, and lungs are at risk for poorer psychological and physical outcomes and may benefit from proactive interventions to optimize function.
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Affiliation(s)
- Jenna L Hansen
- Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, 6001 Research Park Blvd, Milwaukee, WI, 53719, USA
| | - Mark B Juckett
- Masonic Cancer Center, University of Minnesota, 420 Delaware Street SE Minneapolis, Minneapolis, MN, 55455, USA
| | - Mikayla A Foster
- Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, 6001 Research Park Blvd, Milwaukee, WI, 53719, USA
| | - Meredith E Rumble
- Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, 6001 Research Park Blvd, Milwaukee, WI, 53719, USA
- Center for Sleep Medicine and Research, University of Wisconsin-Madison, Madison, WI, USA
| | - Keayra E Morris
- Department of Psychiatry, Medical College of Wisconsin, 900 N 92nd St, Milwaukee, WI, 53226, USA
| | - Peiman Hematti
- Division of Hematology, Medical Oncology, and Palliative Medicine, Department of Medicine, School of Medicine and Public Health, University of Wisconsin, 1685 Highland Avenue, Madison, WI, 53705, USA
- University of Wisconsin Carbone Cancer Center, 1111 Highland Ave, Madison, WI, 53705, USA
| | - Erin S Costanzo
- Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, 6001 Research Park Blvd, Milwaukee, WI, 53719, USA.
- University of Wisconsin Carbone Cancer Center, 1111 Highland Ave, Madison, WI, 53705, USA.
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de Oliveira da Silva P, Orlandini GM, Paz A, Dillenburg CS, Michalowski MB, Daudt LE. Impact of allogeneic stem cell transplantation in childhood and adolescence on quality of adulthood life: A case-control study. Pediatr Transplant 2022; 26:e14330. [PMID: 35709017 DOI: 10.1111/petr.14330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 04/20/2022] [Accepted: 05/16/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is associated with late complications that can impair the quality of life (QoL) of patients for years after transplant. The purpose of the present study was to determine the difference in the QoL of adults that underwent allo-HSCT in childhood and adolescence compared with not transplanted adults. METHODS In this prospective case-control cross-sectional study, we included patients aged ≥18 years that received an allo-HSCT during childhood or adolescence and subsequently survived at least 2 years after transplantation. The control group consisted of blood donors matched for age and sex. QoL assessment was performed using the Short Form-36 (SF-36) Health Survey, Portuguese version 2. RESULTS Thirty-four transplanted patients and controls were included. 58.8% were male, and the median age at transplant was 13.5 years (range, 4-17 years). The median follow-up was 11.5 years (range, 2.0-23.0 years). The most common late effect was skeletally followed by endocrine complications. Patients with these late complications had the worst QOL in the following dimensions: physical functioning, role physical, bodily pain, general health, and mental health. When compared to the control group, patients had a lower score in two dimensions: physical functioning and role physical. CONCLUSIONS Although skeletal and endocrine complications of transplant patients in childhood have an impact on physical functioning, most parameters of QoL of these patients in adulthood are similar to healthy individuals of the same age and gender. Early detection and long-term monitoring of late complications can prevent impairment of the QoL.
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Affiliation(s)
- Priscila de Oliveira da Silva
- Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil.,Graduate Program in Child and Adolescent Health, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | | | - Alessandra Paz
- Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | | | - Mariana Bohns Michalowski
- Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil.,Graduate Program in Child and Adolescent Health, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Liane Esteves Daudt
- Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil.,Graduate Program in Child and Adolescent Health, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
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Rostagno E, Campanati A, Mordini N, Cannici C, Cioce M, De Cecco V, Samarani E, Foà R, Olivieri A, Botti S. Phototherapy and topical treatments for cutaneous graft versus host disease in hematopoietic stem cell transplantation patients: A scoping review. J Eur Acad Dermatol Venereol 2022; 36:1003-1015. [DOI: 10.1111/jdv.18074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 02/17/2022] [Indexed: 11/28/2022]
Affiliation(s)
- E. Rostagno
- Pediatric Oncology and Hematology Unit IRCCS Azienza Ospedaliero Universitaria di Bologna Via Massarenti 11 ‐ 40138 Bologna Italy
| | - A. Campanati
- Dermatology Unit Department of Clinical and Molecular Sciences United Hospitals of Ancona and Polytechnic Marche University Via Conca 70 ‐ 60200 Ancona Italy
| | - N. Mordini
- Hematology Division Azienda Ospedaliera S. Croce e Carle Via Coppino 26 ‐ 12100 Cuneo Italy
| | - C. Cannici
- Hematology Unit AO SS Antonio e Biagio e Cesare Arrigo di Alessandira Via Venezia 16 ‐ 15121 Alessandria Italy
| | - M. Cioce
- UOC SITRA Fondazione Policlinico Universitario A. Gemelli – IRCCS Largo Agostino Gemelli 00168 Roma Italy
| | - V. De Cecco
- Trapianto Emopoietico e Terapia Cellulare Ospedale Pediatrico Bambino Gesù Piazza di Sant'Onofrio 4 ‐ 00165 Roma Italy
| | - E. Samarani
- Unit of Blood Diseases and Stem Cell Transplantation Department of Clinical Oncology ASST Spedali Civili di Brescia Piazzale Spedali Civili 1 ‐ 25123 Brescia Italy
| | - R. Foà
- Department of Translational and Precision Medicine Sapienza University of Rome Via Benevento 6 ‐ 00165 Italy
| | - A. Olivieri
- Clinic of Hematology United Hospitals of Ancona and Polytechnic Marche University Via Conca 71 ‐ 60126 Ancona Italy
| | - S. Botti
- Hematology Unit Azienda USL‐IRCCS Reggio Emilia Viale Risorgimento 80 42123 Reggio Emilia Italy
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