Posttraumatic stress symptoms predict impaired neutrophil recovery in stem cell transplant recipients.

Authors:
Dr Henry Fung, MBchB FRCPE FACP
Dr Henry Fung, MBchB FRCPE FACP
Fox Chase Cancer Center
Vice-Chair, Department of Hematology and Oncology
Cellular therapy
Philadelphia , PA | United States

Psychooncology 2015 Nov 27;24(11):1529-35. Epub 2015 Jan 27.

Department of Medical Oncology, Fox Chase Cancer Center, Philadelphia, PA, USA.

Objective: Despite the potentially life-saving effects of stem cell transplant (SCT), many transplant patients experience traumatic stress reactions due to mortality threat, interpersonal isolation, financial and occupational loss, and invasive medical procedures. Emerging evidence suggests that trauma-related stress symptoms (TSS) predict significant health complications following SCT. The aim of the current prospective study was to examine TSS in the acute aftermath of SCT as a predictor of neutrophil recovery following SCT, a crucial component of immune defense against infection.

Methods: Fifty-one autologous SCT recipients were assessed for TSS 7 days after SCT. Patients' absolute neutrophil counts were collected from medical charts for the first 30 days following SCT. Hierarchical linear growth modeling was used to test the hypothesis that TSS at day 7 would be associated with delayed recovery of neutrophil counts from days 9 to 30 post SCT, that is, when neutrophil counts began to recover.

Results: As hypothesized, TSS measured 7 days after SCT was significantly associated with slower neutrophil recovery even after pre-existing TSS, depression, distress related to physical symptoms, and potential medical confounds were statistically controlled. Exploratory analyses showed that of the TSS symptom clusters, re-experiencing symptoms and hyperarousal symptoms predicted neutrophil recovery, whereas avoidance symptoms did not.

Conclusion: Though traumatic stress symptoms may be a normative response to SCT, our findings suggest that TSS following SCT may interfere with neutrophil recovery and overall health. These results provide further insight as to potential mechanisms by which traumatic stress translates to poor medical outcomes for SCT patients.

Download full-text PDF

Source
http://dx.doi.org/10.1002/pon.3761DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4516698PMC
November 2015
24 Reads
2 Citations
2.443 Impact Factor

Publication Analysis

Top Keywords

neutrophil recovery
20
sct
12
traumatic stress
12
neutrophil counts
12
days sct
12
stress symptoms
12
stem cell
8
cell transplant
8
tss
8
neutrophil
8
symptoms
7
recovery
6
days
4
sct patients'
4
recipients assessed
4
tss days
4
patients' absolute
4
assessed tss
4
symptoms predicted
4
hyperarousal symptoms
4

References

(Supplied by CrossRef)
Posttraumatic stress disorder (PTSD) in survivors of Hodgkin's lymphoma: prevalence of PTSD and partial PTSD compared with sibling controls
Varela et al.
Psycho-Oncology 2013

Vose et al.
2011

Similar Publications