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焦虑和抑郁预示急性髓系白血病患者的生存预后不良。

Anxiety and depression predict unfavorable survival in acute myeloid leukemia patients.

作者信息

Ding Ting, Wang Xin, Fu Adan, Xu Liwen, Lin Jing

机构信息

Department of Hematology.

Department of Nursing, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

出版信息

Medicine (Baltimore). 2019 Oct;98(43):e17314. doi: 10.1097/MD.0000000000017314.

Abstract

This study aimed to investigate the prevalence/severity of anxiety and depression, and also their correlations with clinical characteristics and survival profiles in acute myeloid leukemia (AML) patients.In all, 208 AML patients and 200 age and sex-matched healthy controls (HCs) were recruited in this study. Anxiety and depression were assessed by the Hospital Anxiety and Depression Scale (HADS) in AML patients before initiating therapy and in HCs after being enrolled. Treatment response was assessed, and event-free survival (EFS), and also the overall survival (OS) were calculated.The HADS-anxiety score (P < .001), anxiety prevalence (P < .001), and anxiety severity (P < .001) were increased in AML patients than those in HCs. The HADS-depression score (P < .001), depression prevalence (P < .001), and also depression severity (P < .001) were higher in AML patients compared with HCs. No correlation of anxiety or depression with clinical characteristics was found in AML patients (all P > .05). Moreover, the anxiety (P = .178) and depression (P = .512) rates were similar between complete remission (CR) patients and non-CR patients. Additionally, the EFS was worse in anxiety patients compared with nonanxiety patients (P = .013). The OS was shorter in anxiety patients compared with nonanxiety patients (P = .015) and was also worse in depression patients compared with nondepression patients (P = .007).Anxiety and depression are much more frequent and severe in AML patients compared to HCs, and both of them predict unfavorable survival profiles in AML patients.

摘要

本研究旨在调查急性髓系白血病(AML)患者焦虑和抑郁的患病率/严重程度,以及它们与临床特征和生存情况的相关性。本研究共纳入了208例AML患者以及200例年龄和性别匹配的健康对照(HCs)。在AML患者开始治疗前,通过医院焦虑抑郁量表(HADS)对其焦虑和抑郁情况进行评估;在HCs入组后,也采用该量表进行评估。评估治疗反应,并计算无事件生存期(EFS)和总生存期(OS)。与HCs相比,AML患者的HADS焦虑评分(P<0.001)、焦虑患病率(P<0.001)和焦虑严重程度(P<0.001)均升高。与HCs相比,AML患者的HADS抑郁评分(P<0.001)、抑郁患病率(P<0.001)以及抑郁严重程度(P<0.001)均更高。在AML患者中,未发现焦虑或抑郁与临床特征之间存在相关性(所有P>0.05)。此外,完全缓解(CR)患者和非CR患者的焦虑率(P=0.178)和抑郁率(P=0.512)相似。此外,与非焦虑患者相比,焦虑患者的EFS更差(P=0.013)。与非焦虑患者相比,焦虑患者的OS更短(P=0.015);与非抑郁患者相比,抑郁患者的OS也更差(P=0.007)。与HCs相比,AML患者的焦虑和抑郁更为常见且严重,并且二者均预示着AML患者的生存情况不佳。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/33af/6824643/24ad86f69ee2/medi-98-e17314-g002.jpg

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