title: Posttraumatic stress symptoms predict impaired neutrophil recovery in stem cell transplant recipients.
abstract: 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.
  
  
  CONCLUSIONS
  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.
authors: Department of Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA.
authors: Stevan E
authors: SE
authors: Hobfoll
authors: Department of Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA.
authors: James I
authors: JI
authors: Gerhart
authors: Department of Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA.|Department of Psychiatry, Rush University Medical Center, Chicago, IL, USA.
authors: Alyson K
authors: AK
authors: Zalta
authors: Cancer Treatment Centers of America, Philadelphia, PA, USA.
authors: Kurrie
authors: K
authors: Wells
authors: The Coleman Foundation Blood and Bone Marrow Transplant Program, Rush University Medical Center, Chicago, IL, USA.
authors: John
authors: J
authors: Maciejewski
authors: Department of Medical Oncology, Fox Chase Cancer Center, Philadelphia, PA, USA.
authors: Henry
authors: H
authors: Fung
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000502:physiology*; D011446:Prospective Studies; D033581:Stem Cell Transplantation / Q000009:adverse effects* / Q000523:psychology*; D013313:Stress Disorders, Post-Traumatic / Q000503:physiopathology*; D014182:Transplantation, Autologous
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