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FRED HUTCHINSON STUDY SHOWS MODERATE STRESS CAN AID IN RECOVERY FROM STEM CELL TRANSPLANT | |
| Contact: Dean Forbes Phone: 206-667-2986 Email: dforbes@fhcrc.org Embargoed until: March 4, 2005 |
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Vancouver, BC, Canada - Psychological distress can influence immune recovery after hematopoietic cell transplantation (HCT) for cancer, according to findings by researchers at Fred Hutchinson Cancer Research Center in Seattle, WA. But distress is not necessarily harmful. Too little distress can be as damaging as too much distress for patients in the early stages of recovery. Instead, moderate levels of distress best enable the body to recoup its immune function in the early weeks following high dose HCT. The findings were presented at the American Psychosomatic Society Annual Meeting. This is the first study to associate psychological distress with the reconstitution of white blood cells following transplants of patients' own stem cells to treat blood cancers. Bonnie McGregor, PhD, of the center's Public Health Sciences Division and colleagues examined the effects of distress on the white blood cell counts of 71 adult stem cell transplant patients who received their own cells following high doses of chemotherapy or radiation to destroy their diseased cells. Pre-transplant distress was measured two to 14 days before hospital admission using the Cancer and Treatment Distress scale and the anxiety and depression subscales of the Symptom Checklist-90-R. White blood cell counts were measured on days 5 through 21 following transplant, by which time most patients have initial immune recovery. The level of white blood cell development is an indicator of immune system repair following the transplant. The results showed an inverted U-shaped relationship in which moderate levels of distress resulted in the most rapid progress for reconstituting the immune system. "Although greater depression predicted slower immune recovery, either too high or too low levels of distress predicted slower recovery," said McGregor. "Stress moderates immune recovery during stem cell transplantation and appropriate levels of stress may be more protective than either too much or too little." Co-author Karen Syrjala, PhD, head of biobehavorial sciences at Fred Hutchinson, said, "it is a highly unsettling experience going into cancer treatment. The normal response is to have some distress. An appropriate amount of worry and concern helps you prepare, both emotionally and physiologically." "Too little stress means you are not reacting to what you should be," said Syrjala. "The middle ground is where most of us want to be and do our best work." She said behavioral medicine experts are moving away from the idea of "white knuckle positive thinking that supported the notion that you can only have positive thoughts and that negative thoughts will somehow kill you. We know that is not true. What seems to be most hazardous is being out of touch with or suppressing what you feel." The authors say that the current study further underscores the importance of careful psychological evaluation of, and treatment for, transplant patients. Treating depression, elevated stress or lack of distress might help the immune systems of these patients recovery more quickly. | |
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Psychosomatic Medicine is the official peer-reviewed journal of the American Psychosomatic Society, published bimonthly. For information about the journal, contact Vicki White, Managing Editor for Manuscript Production,
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