title: Mental adjustment to cancer and survival of patients admitted for allogenic hemopoietic stem cell transplantation - a prospective cohort study.
abstract: OBJECTIVE
  The Mental Adjustment to Cancer Scale (MAC scale) has evolved to a standard measure in the field of psycho-oncology. In this context an attitude called "fighting spirit" gained much attention as a coping style. Some reports suggest that coping efforts as measured by the MAC scale are predictive for survival of breast cancer patients. We explored the predictive power of the MAC scale by using a sample of patients with haematological malignancies undergoing allogenic hemopoietic stem cell transplantation (HSCT).
  
  
  METHODS
  Between 9/1999 and 12/2001 127 patients were administered the MAC scale prior to HSCT. Follow-up data of overall survival and event-free survival were obtained in December 2003 and analyzed using Cox-regression models.
  
  
  RESULTS
  At the time of the follow-up, 68 patients had died (overall survival), 75 patients had experienced a relapse or had died (event-free survival). We failed to find significant results for the MAC subscales with and without adjustment for prognostic factors.
  
  
  CONCLUSIONS
  In the special situation of patients facing HSCT the MAC scale seems not to be of predictive value. In general, with respect to survival the empirical evidence is not very convincing.
authors.affiliation: Universitätsklinik für Psychosomatische Medizin und Psychotherapie, Ulm, Germany. norbert.grulke@uni-ulm.de
authors.forename: Norbert
authors.initials: N
authors.lastname: Grulke
authors.forename: Harald
authors.initials: H
authors.lastname: Bailer
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Larbig
authors.forename: Horst
authors.initials: H
authors.lastname: Kächele