Prieto J M, Atala J, Blanch J, Carreras E, Rovira M, Cirera E, Gastó C
Department of Psychiatry, Clinical Institute of Psychiatry and Psychology, IDIBAPS, Hospital Clínic, University of Barcelona, Barcelona, Spain.
Bone Marrow Transplant. 2005 Feb;35(3):307-14. doi: 10.1038/sj.bmt.1704788.
In this 3-year prospective inpatient study, 220 patients received stem-cell transplantation (SCT) for hematologic cancer at a single institution. The objective of the study is to provide data on patient-rated emotional (depression and anxiety) and physical (overall physical status, energy level, and systemic symptomatology) functioning during hospitalization for SCT and to compare whether these differ between autologous and allogeneic SCT. Patients were assessed at hospital admission (T1), day of SCT (T2), and 7 days (T3) and 14 days (T4) after SCT, yielding a total of 852 evaluations. For the overall sample, anxiety was highest at T1 and decreased afterwards; a marked worsening in physical health status variables corresponded with a sharp increase in depression from T1 to T3, and was followed by an improvement in physical health and a reduction of depression. Compared to allogeneic SCT, a better physical outcome for autologous SCT was demonstrated by the significant group effect for systemic symptomatology and by the significant group x time interaction for overall physical status and energy level; there were no significant differences in depression or anxiety between SCT groups. These findings have implications for treatment decision making, coping with the transplantation process, and improving prevention and treatment strategies.
在这项为期3年的前瞻性住院患者研究中,220例血液系统癌症患者在单一机构接受了干细胞移植(SCT)。本研究的目的是提供关于患者在SCT住院期间自评的情绪(抑郁和焦虑)及身体(总体身体状况、能量水平和全身症状)功能的数据,并比较自体和异体SCT之间这些功能是否存在差异。在入院时(T1)、SCT当天(T2)以及SCT后7天(T3)和14天(T4)对患者进行评估,共得到852次评估。对于总体样本,焦虑在T1时最高,之后下降;身体健康状况变量的显著恶化与从T1到T3抑郁的急剧增加相对应,随后身体健康状况有所改善,抑郁程度降低。与异体SCT相比,自体SCT在全身症状方面的显著组效应以及在总体身体状况和能量水平方面的显著组×时间交互作用表明其身体结局更好;SCT组之间在抑郁或焦虑方面无显著差异。这些发现对治疗决策、应对移植过程以及改进预防和治疗策略具有启示意义。