Psychiatric and psychosocial challenges in patients undergoing haematopoietic stem cell transplants

Abstract

Haematological malignancies are often treated with haematopoietic stem cell transplants (HSCT). The disease and its treatment are challenging and life threatening, as they not only affect the recipients, but also their families. This review highlights the available data on the psychological, psychiatric and social impact of these illnesses and their treatment on recipients and families. There are robust data that correlate HSCT with emotional distress, as emotional and physical functioning significantly affect quality of life. Psychiatric co-morbidity including anxiety, depression, adjustment and post-traumatic stress disorder, delirium and cognitive deficits have been reported at different stages in the transplant process. This review will highlight the psychosocial and clinical research findings relevant to HSCT patients and will summarize recommendations for future psychosocial research in this population.

Quality of Life and Psychopathology in Adults Who Underwent Hematopoietic Stem Cell Transplantation (HSCT) in Childhood: A Qualitative and Quantitative Analysis

“…HSCT is characterized by a complex medical nature that involves invasive medical procedures associated with extended hospitalizations, long periods of isolation, adverse side effects, risk of mortality or relapse, and long recovery periods (Rueda-Lara and Lopez-Patton, 2014 ). Patients face substantial changes in their physical functioning due to symptoms such as fatigue, dry mouth, loss of appetite, nausea, and mucositis (Rueda-Lara and Lopez-Patton, 2014 ).…”

“…HSCT is characterized by a complex medical nature that involves invasive medical procedures associated with extended hospitalizations, long periods of isolation, adverse side effects, risk of mortality or relapse, and long recovery periods (Rueda-Lara and Lopez-Patton, 2014 ). Patients face substantial changes in their physical functioning due to symptoms such as fatigue, dry mouth, loss of appetite, nausea, and mucositis (Rueda-Lara and Lopez-Patton, 2014 ). Even when the transplantation is carried out successfully, recipients are at risk of short- and long-term medical consequences such as chronic Graft-vs.-Host Disease (GvHD), infections, secondary malignancies, endocrine dysfunction, and different physical symptoms like pain, nausea, and fatigue (Lowe et al, 2007 ).…”

“…First, taking survivors' perspectives into account could help researchers to reach a better and more complete understanding of their experience (Bevans, 2010 ). Second, continuous screening could help to identify risk factors for psychological distress, facilitating and guiding appropriate interventions, and ultimately improving outcomes (Rueda-Lara and Lopez-Patton, 2014 ).…”

Functional Assessment of Fatigue and Other Patient-Reported Outcomes in Patients Enrolled in the Global aHUS Registry

“…Given that fatigue is associated with impaired productivity, depression, and decreased quality of life, and strongly associated with functional decline, [23][24][25] the benefits of eculizumab on fatigue are likely to be valued by patients. The change in FACIT-Fatigue scores in patients treated with eculizumab in this current analysis is similar to what has previously been reported in an eculizumab clinical trial in adult patients with aHUS.…”

Palliative care during and following allogeneic hematopoietic stem cell transplantation

“…The burden of unmet psychological needs is similarly high among adults undergoing HSCT and in HSCT survivors, and includes anxiety, depression, psychological distress (including worry, uncertainty, and fear of recurrence), post-traumatic stress disorder, treatment-related financial burden, and cognitive impairment(5, 18–22). There is evidence that psychological issues are underrecognized and undertreated(18, 23, 24).…”