Pre-transplant depression as risk factor for survival of patients undergoing allogeneic haematopoietic stem cell transplantation.
BACKGROUND
Depression is discussed as a possible risk factor for survival in cancer patients. We explored this relationship for patients undergoing allogeneic haematopoietic stem cell transplantation (HSCT).


METHODS
The depression subscale of the Hospital Anxiety and Depression Scale (HADS) served as a measure for depression. One hundred and thirty-eight patients (mean age 41 years; different diagnoses) participating in a psycho-oncology study filled in the HADS after admission for allogeneic HSCT. They were followed-up for at least two years; 72 patients died during follow-up.


RESULTS
Depression scores were not correlated with medical and psychosocial objective factors with the exception of having under-aged children. Controlling for medical factors that showed up as predictors for survival in our sample (patient's age at HSCT, having had a transplant before, risk for treatment failure) the HADS depression score (range 0-21) emerged as an independent predictor (Cox regression): hazard ratio = 1.087, 95% CI = 1.018-1.161.


CONCLUSIONS
Depression is probably not a simple indicator of a worse health status. Further research is needed to decide if depression must be considered as an independent risk factor for survival when diagnosed in the pre-transplant period.
Grulke
Norbert
N
University Clinic for Psychosomatic Medicine and Psychotherapy, Ulm University, Ulm, Germany. norbert.grulke@uniulm.de
Larbig
Wolfgang
W
Kächele
Horst
H
Bailer
Harald
H
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D003866:Depressive Disorder / Q000150:complications* / Q000175:diagnosis / Q000401:mortality / Q000523:psychology; D005191:Family Characteristics; D005260:Female; D005500:Follow-Up Studies; D018380:Hematopoietic Stem Cell Transplantation / Q000401:mortality* / Q000523:psychology*; D006801:Humans; D053208:Kaplan-Meier Estimate; D007938:Leukemia / Q000401:mortality / Q000523:psychology* / Q000628:therapy*; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000401:mortality / Q000523:psychology* / Q000628:therapy*; D008228:Lymphoma, Non-Hodgkin / Q000401:mortality / Q000523:psychology* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010555:Personality Inventory / Q000706:statistics & numerical data; D011379:Prognosis; D011594:Psychometrics; D019233:Retreatment; D012307:Risk Factors; D013223:Statistics as Topic; D017211:Treatment Failure