Pre-transplant depression as risk factor for survival of patients undergoing allogeneic haematopoietic stem cell transplantation.

INTRODUCTION

Depression is discussed as a possible risk factor for survival in cancer patients. We explored this relationship for patients undergoing allogeneic haematopoietic stem cell transplantation (HSCT).

PATIENTS AND METHODS

The depression subscale of the Hospital Anxiety and Depression Scale (HADS) served as a measure for depression. One hundred and thirty-eight patients (mean age 41 years; different diagnoses) participating in a psycho-oncology study filled in the HADS after admission for allogeneic HSCT. They were followed-up for at least two years; 72 patients died during follow-up.

RESULTS

Depression scores were not correlated with medical and psychosocial objective factors with the exception of having under-aged children. Controlling for medical factors that showed up as predictors for survival in our sample (patient's age at HSCT, having had a transplant before, risk for treatment failure) the HADS depression score (range 0-21) emerged as an independent predictor (Cox regression): hazard ratio = 1.087, 95% CI = 1.018-1.161.

CONCLUSION

Depression is probably not a simple indicator of a worse health status. Further research is needed to decide if depression must be considered as an independent risk factor for survival when diagnosed in the pre-transplant period.