Comparison of temporal changes in psychological distress after hematopoietic stem cell transplantation among the underlying diseases of Japanese adult patients

Abstract

Background: Although hematopoietic stem cell transplantation (HSCT) can potentially cure some hematological malignancies, patients who undergo HSCT experience psychological distress. However, there have been few studies on the short-term influence of HSCT on psychological distress.

Methods: The subjects were 71 patients with hematological malignancies who underwent HSCT: 33 with acute leukemia, 19 with chronic leukemia, nine with myelodysplastic syndrome, and 10 with malignant lymphoma. Psychological distress was assessed prior to HSCT and on the seventh day after HSCT using the Profile of Mood States (POMS).

Results: With regard to Anger-Hostility, the interaction of time (pre- and post-HSCT) and group (the four groups) was significant in male patients (p = 0.04), but not in female patients. With regard to the other subscales of POMS, there was no significant main effect or interaction in male or female patients.

Conclusion: It may be important to provide psychological support to patients throughout the period of HSCT in consideration of differences in mood changes associated with the underlying disease and patient sex in order to provide efficient psychiatric intervention for both better psychiatric and survival outcomes.

Figure 1

Temporal changes in POMS Anger-Hostility score before and after HSCT. Changes in Anger-Hostility scores between pre- and post-hematopoietic stem cell transplantation (HSCT) are displayed by disease group. For male patients, the interaction of time and group was significant (p = 0.04) (A). However, for female patients there was no significant main effect or interaction (B). Patients with higher Anger-Hostility scores have more distress. T1, time point of pre-HSCT; T2, seventh day after HSCT. The mean score (SD) of Anger-Hostility for men in the Japanese general population (n = 3154) is 10.8 (8.2) while that of women in the Japanese general population (n = 2423) is 10.9 (8.8) [9].