Anxiety, depression, and mental health-related quality of life in survivors of pediatric allogeneic hematopoietic stem cell transplantation: a systematic review

Giuseppe, Giancarlo Di; Thacker, Nirav; Schechter, Tal; Pole, Jason D.

doi:10.1038/s41409-020-0782-z

Cited by 44 publications

(42 citation statements)

References 52 publications

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“…Taken together, these findings emphasize the need for systematic evaluation of Leydig cell function during puberty and into adulthood to allow timely treatment of testosterone deficiency. This may in turn lower the risk of other late effects potentially linked to testosterone deficiency such as altered body composition, metabolic syndrome, low bone mineral density as well as fatigue and depression ( 23 ) – conditions that are frequently reported in these patients ( 24 , 25 , 26 ).…”

Section: Discussionmentioning

confidence: 99%

Childhood reproductive hormone levels after pediatric hematopoietic stem cell transplantation in relation to adult testicular function

Mathiesen

Sørensen

Ifversen

et al. 2021

Endocrine Connections

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Objectives: Longitudinal assessment of testicular function after pediatric hematopoietic stem cell transplantation (HSCT) is needed to guide clinical follow-up. We investigated dynamics in male reproductive hormones after pediatric HSCT, focusing on pubertal timing and associations with testosterone deficiency and azoospermia in adulthood. Methods: This retrospective, longitudinal study included 39 survivors median 19 years after pediatric HSCT. Serum concentrations of LH, testosterone, FSH, and inhibin B from time of HSCT, during puberty, and into adulthood were analyzed. Pubertal timing (rise in LH and testosterone) was compared to a reference cohort of 112 healthy boys. Associations between reproductive hormone levels during puberty and adult testicular function (including semen quality) were investigated. Results: Pubertal induction with testosterone was needed in 6/26 patients who were prepubertal at HSCT. In the remaining patients, pubertal timing was comparable to the reference cohort. However, 9/33 patients (without pubertal induction) developed testosterone deficiency in early adulthood, which was associated with higher LH levels from age 14–16 years. Azoospermia in adulthood was found in 18/26 patients without testosterone substitution. Higher FSH and lower inhibin B levels from mid-pubertal age were associated with azoospermia in adulthood, in patients being prepubertal at HSCT. Conclusion: Our results indicate a substantial risk of deterioration in testicular function after pediatric HSCT, despite normal pubertal timing. Although reproductive hormone levels from mid-puberty indicated adult testicular function, prolonged follow-up into adulthood is needed in these patients, including clinical examination, reproductive hormone analysis, and semen sample for patients interested in their fertility potential.

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Section: Discussionmentioning

confidence: 99%

Childhood reproductive hormone levels after pediatric hematopoietic stem cell transplantation in relation to adult testicular function

Mathiesen

Sørensen

Ifversen

et al. 2021

Endocrine Connections

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“…A review study that aimed to determine the association between HSCT, anxiety, depression, and psychological quality found that the anxiety and depression rates were higher in HSCT survivors when compared to values of the general population. The presence of multiple complications and the patients' chronic conditions were important risk factors for deterioration in mental health (19).…”

Section: Discussionmentioning

confidence: 99%

Cognitive Impairment and Quality of Life of Patients Subjected to Hematopoietic Stem Cell Transplantation

et al. 2021

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Objective: To assess and correlate overall quality of life and the cognitive function of adult patients with hematologic cancer subjected to autologous and allogeneic hematopoietic stem cell transplantations up to three years after treatment. Materials and method: A longitudinal, observational, and analytical study was conducted with 55 patients in a reference hospital in Latin America, from September 2013 to February 2019, with the Quality of Life Questionnaire-Core 30, analyzed with the Spearman’s correlation coefficient and Generalized Linear Mixed Model tests. Results: Overall quality of life in autologous and allogeneic transplantations presented a decline in the pancytopenia phase (59.3 and 55.3, respectively). There was impairment of the cognitive function in the autologous group in post-transplantation after two years (61.90) and, in the allogeneic group (74), in pancytopenia. In the autologous group, a positive (0.76) and significant (p < 0.04) correlation is observed between the cognitive domain and quality of life in post-transplantation after two years. In the allogeneic group, there was a positive (0.55) and significant (p < 0.00) correlation from 180 days after transplantation. Conclusions: Quality of life and the cognitive function present impairment and there is a correlation after the hematopoietic stem cell transplantation for both groups: autologous and allogeneic.

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“…Hematopoietic stem cell transplantation (HSCT) is widely used in pediatric patients with malignant and non-malignant disorders [1,2]. HSCT is a successful therapy offering the possibility of a cure for life-threatening conditions; however, it is an intensive treatment with risk of serious complications, significant physical and psychological symptoms, poor quality of life (QoL), and can be lethal [3][4][5][6]. As reported in previous studies, pediatric patients who died following HSCT were often treated in the pediatric intensive care unit (PICU) with invasive treatments during End-of-Life (EOL) [4,[6][7][8].…”

Section: Introductionmentioning

confidence: 99%

Specialized Pediatric Palliative Care Services in Pediatric Hematopoietic Stem Cell Transplant Centers

et al. 2021

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Hematopoietic stem cell transplantation (HSCT) is widely used in pediatric patients as a successful curative therapy for life-threatening conditions. The treatment is intensive, with risks of serious complications and lethal outcomes. This study aimed to provide insight into current data on the place and cause of death of transplanted children, the available specialized pediatric palliative care services (SPPCS), and what services HSCT professionals feel the SPPCS team should provide. First, a retrospective database analysis on the place and cause of death of transplanted pediatric HSCT patients was performed. Second, a survey was performed addressing the availability of and views on SPPCS among HSCT professionals. Database analysis included 233 patients of whom the majority died in-hospital: 38% in the pediatric intensive care unit, 20% in HSCT units, 17% in other hospitals, and 14% at home or in a hospice (11% unknown). For the survey, 98 HSCT professionals from 54 centers participated. Nearly all professionals indicated that HSCT patients should have access to SPPCS, especially for pain management, but less than half routinely referred to this service at an early stage. We, therefore, advise HSCT teams to integrate advance care planning for pediatric HSCT patients actively, ideally from diagnosis, to ensure timely SPPCS involvement and maximize end-of-life preparation.

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Anxiety, depression, and mental health-related quality of life in survivors of pediatric allogeneic hematopoietic stem cell transplantation: a systematic review

Cited by 44 publications

References 52 publications

Childhood reproductive hormone levels after pediatric hematopoietic stem cell transplantation in relation to adult testicular function

Childhood reproductive hormone levels after pediatric hematopoietic stem cell transplantation in relation to adult testicular function

Cognitive Impairment and Quality of Life of Patients Subjected to Hematopoietic Stem Cell Transplantation

Specialized Pediatric Palliative Care Services in Pediatric Hematopoietic Stem Cell Transplant Centers

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