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Kelly DL, Syrjala K, Taylor M, Rentscher KE, Hashmi S, Wood WA, Jim H, Barata A, Flynn KE, Burns LJ, Shaw BE, Petersdorf E, Yero AC, Emmrich AD, Morris KE, Costanzo ES, Knight JM. Biobehavioral Research and Hematopoietic Stem Cell Transplantation: Expert Review from the Biobehavioral Research Special Interest Group of the American Society for Transplantation and Cellular Therapy. Transplant Cell Ther 2021; 27:747-757. [PMID: 34139388 DOI: 10.1016/j.jtct.2021.06.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 06/04/2021] [Accepted: 06/07/2021] [Indexed: 01/12/2023]
Abstract
Hematopoietic stem cell transplantation (HCT) is a potentially curative treatment for many hematologic conditions. Despite advances in conditioning and supportive measures, however, there remain significant comorbidities that threaten survivorship. Adverse effects of stress-related biobehavioral processes-defined here as the interactions of behavioral, psychological, and socioenvironmental factors with biology-impact immune recovery and function and are particularly salient in the HCT context, given the importance of immune reconstitution for improved survivorship. However, biobehavioral processes have been underinvestigated in this vulnerable group compared with other cancer populations. Here the Biobehavioral Research Special Interest Group (SIG) of the American Society for Transplantation and Cellular Therapy provides an expert review to inform research directions explicating the biological correlates of behavioral symptoms and evaluate the impact of these on HCT outcomes. The goal of this expert review is to provide a foundation for advancing science that effectively integrates behavioral and biological processes to optimize quality of life and improve clinical outcomes for HCT recipients.
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Affiliation(s)
- Debra Lynch Kelly
- Department of Biobehavioral Nursing Science, College of Nursing, University of Florida and University of Florida Health Cancer Center, Gainesville, Florida
| | - Karen Syrjala
- Biobehavioral Sciences Department, Fred Hutchinson Cancer Research Center and University of Washington School of Medicine, Seattle, Washington
| | - Mallory Taylor
- Division of Hematology-Oncology, Department of Pediatrics, University of Washington, Seattle, Washington
| | - Kelly E Rentscher
- Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, California
| | - Shahrukh Hashmi
- Department of Hematology and Onclolgy; Sheikh Shakhbout Medical City/Mayo Clinic, Abu Dhabi, United Arab Emirates
| | - William A Wood
- Division of Hematology, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Heather Jim
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida
| | - Anna Barata
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida
| | - Kathryn E Flynn
- Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Linda J Burns
- Center for International Blood and Marrow Transplant Research, Milwaukee, Wisconsin
| | - Bronwen E Shaw
- Center for International Blood and Marrow Transplantation Research, Froedtert and the Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Effie Petersdorf
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Anela Carrazana Yero
- Department of Biobehavioral Nursing Science, University of Florida, Gainesville, Florida
| | - Amanda D Emmrich
- Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Keayra E Morris
- Department of Psychiatry, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Erin S Costanzo
- Department of Psychiatry and Carbone Cancer Center, University of Wisconsin-Madison, Madison, Wisconsin
| | - Jennifer M Knight
- Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin; Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin; Department of Microbiology and Immunology, Medical College of Wisconsin, Milwaukee, Wisconsin.
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Mapping the Affective Dimension of Embodiment With the Sensation Manikin: Validation Among Chronic Pain Patients and Modification by Mindfulness-Oriented Recovery Enhancement. Psychosom Med 2019; 81:612-621. [PMID: 31246748 DOI: 10.1097/psy.0000000000000725] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVE Mindfulness-based interventions target novel pain relief mechanisms not captured by legacy pain scales, including 1) cultivating awareness of pleasant and neutral sensations proximal to unpleasant sensations and 2) interoceptively mapping sensation location and spatial distribution. METHODS We created a digital sensation manikin (SM) by overlaying a human figure silhouette with a grid of 469 "sensation" pixels. A series of five research questions examined the SM's discriminant validity, construct validity, incremental validity, convergence with an objective measure of pain attentional bias, and sensitivity to a mindfulness-based psychological treatment, Mindfulness-Oriented Recovery Enhancement (MORE). A sample of opioid treated chronic pain patients (n = 108; age, 53.79 (12.94) years; female, 65%) was recruited to answer research questions 1 to 5, and a sample of healthy controls (n = 91; age, 36.47 (13.50) years; female, 55%) was recruited as the comparison group for research question 1. RESULTS Chronic pain patients reported significantly more unpleasant sensations than did healthy controls (p < .001, d = 1.23) and significantly fewer pleasant sensations (p = .001, d = 0.50). The SM also evidenced expected relationships with multiple measures of pain (r = 0.26-0.29) and well-being (r = -0.21 to 0.28), uniquely predicted pain interference (β = -0.18), and exhibited a significant association with pain attentional bias (r = 0.25). Finally, mindfulness-based intervention via MORE significantly increased the ratio of pleasant to unpleasant sensations reported by chronic pain patients relative to an active control condition (p = .036, d = 0.51). CONCLUSIONS This study supports the SM's validity and indicates that assessing both pleasant and unpleasant sensations broadens the scope of pain measurement. Although the SM would benefit from further optimization, its continued use is likely to contribute to improved assessment and treatment options for chronic pain patients.
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