Depression linked to death in stem cell transplants

By
Monday, 07 January, 2002

Researchers at the International Bone Marrow Transplant Registry (IBMTR) at the Medical College of Wisconsin in Milwaukee, and at the Dana-Farber Cancer Institute found that patients with depressive symptoms six months after their transplant have three times higher risk of death by one year post-transplant than do non-depressed patients.

The association between depression and increased mortality is well documented; it has held true with heart disease, cancer, and solid organ transplant patients. But it has not been extensively studied in stem cell transplant patients. The information comes from a statistical analysis of the survival rates of patients with and without depressive symptoms who have had stem cell transplants.

"It is not routine for patients to have a formal psychological screening before stem cell transplants and depression following transplant may not be recognized," says Fausto Loberiza, assistant professor of health policy at the Medical College. "Our finding that patients who are depressed have higher death rates should lead to the next obvious question: could efforts to diagnose and treat depression improve survival rates?"

The study looked at 313 adult patients with different types of leukemia, myeloma, and lymphoma who had received either autologous or allogeneic transplants at the Dana-Farber Cancer Institute as treatment for their cancers. The patients filled out a Likert-scale symptom checklist and other quality of life instruments. 35% of patients had symptoms associated with depression.

Researchers looked at both the depressed and non-depressed patients again at one year post-transplant. About 70% of the patients who were depressed at six months were still depressed at one year. Other medical factors were controlled for to allow the analysis to focus on depression.

The statistical analysis found the survival rate for depressed patients was 85%, while the survival rate for non-depressed patients was 94%. That difference, 9%, is statistically significant.