%0 Journal Article %J Brain Behav Immun %D 2013 %T The effect of pre-transplant distress on immune reconstitution among adult autologous hematopoietic cell transplantation patients. %A McGregor, Bonnie A %A Syrjala, Karen L %A Dolan, Emily D %A Langer, Shelby L %A Redman, Mary %K Adolescent %K Adult %K Anxiety %K Depression %K Female %K Hematologic Neoplasms %K Hematopoietic Stem Cell Transplantation %K Humans %K Leukocyte Count %K Longitudinal Studies %K Male %K Middle Aged %K Prospective Studies %K Psychiatric Status Rating Scales %K Self Report %K Sex Factors %K Stress, Psychological %K Treatment Outcome %X

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.

%B Brain Behav Immun %V 30 Suppl %P S142-8 %8 2013 Mar %G eng %R 10.1016/j.bbi.2012.07.020