%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 %0 Journal Article %J J Psychosoc Oncol %D 2012 %T Expressive talking among caregivers of hematopoietic stem cell transplant survivors: acceptability and concurrent subjective, objective, and physiologic indicators of emotion. %A Langer, Shelby L %A Kelly, Thomas H %A Storer, Barry E %A Hall, Suzanne P %A Lucas, Heather G %A Syrjala, Karen L %K Adaptation, Psychological %K Adult %K Caregivers %K Communication %K Expressed Emotion %K Female %K Hematopoietic Stem Cell Transplantation %K Humans %K Male %K Middle Aged %K Patient Satisfaction %K Psychotherapy %K Skin Physiological Phenomena %K Stress, Psychological %K Survivors %X

This study sought to examine the effects of an expressive talking intervention for 58 caregiving partners of hematopoietic stem cell transplant survivors, persons known to experience distress. Caregivers were randomly assigned to a three-session emotional expression (EE) or control condition. Subjective, objective, and physiologic indicators of emotion were assessed. Relative to controls, EE participants experienced more negative emotion, uttered more negative emotion words, and perceived the exercises as more helpful and meaningful. The trajectory of skin conductance and the use of cognitive mechanism words increased across EE sessions, suggesting sustained emotional engagement. Future research is warranted to determine the optimal dose and timing of EE for this population.

%B J Psychosoc Oncol %V 30 %P 294-315 %8 2012 %G eng %N 3 %R 10.1080/07347332.2012.664255