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Posttraumatic stress symptoms predict impaired neutrophil recovery in stem cell transplant recipients

Hobfoll SE, Gerhart JI, Zalta AK, Wells K, Maciejewski J, Fung H.

Psychooncology. 2015 Jan 27.

Department of Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA.

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 stem cell transplant. The aim of the current prospective study was to examine trauma-related stress  symptoms in the acute aftermath of stem cell transplant as a predictor of neutrophil recovery following stem cell transplant, a crucial component of immune defense against infection.

METHODS:

Fifty-one autologous stem cell transplant recipients were assessed for trauma-related stress  symptoms 7 days after stem cell transplant. 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 trauma-related stress  symptoms at day 7 would be associated with delayed  recovery  of  neutrophil counts from days 9 to 30 post stem cell transplant, that is, when neutrophil counts began to recover.

RESULTS:

As hypothesized, trauma-related stress  symptoms measured 7 days after stem cell transplant was significantly associated with slower neutrophil  recovery even after pre-existing trauma-related stress  symptoms, depression, distress related to physical symptoms, and potential medical confounds were statistically controlled. Exploratory analyses showed that of the trauma-related stress  symptoms symptom clusters, re-experiencing symptoms and hyperarousal  symptoms  predicted  neutrophil recovery, whereas avoidance symptoms did not.

CONCLUSION:

Though traumatic stress symptoms may be a normative response to stem cell transplant, our findings suggest that trauma-related stress  symptoms following stem cell transplant 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 stem cell transplant patients.

Copyright © 2015 John Wiley & Sons, Ltd.

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