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Emotional Support Before Stem Cell Transplant May Improve Outcomes

Interdisciplinary Study from Northwestern Links Emotional Support to Survival in Cancer Patients after HSCT

Each year, approximately 8,000 allogeneic hematopoietic stem cell transplants (HSCTs) take place each year in the United States. Although this treatment option significantly improves survival for many patients with blood cancers, the benefits are often offset by substantial medical risks, including disease relapse, graft-versus-host-disease and infection, and mortality. In addition, HSCT recipients report experiencing emotional distress associated with lengthy hospital stays, social isolation due to functional limitations, follow-up visits and the financial and emotional burden placed on family members.

Emerging evidence suggests that social support, stress and other psychosocial factors can impact symptom burden and quality of life in BMT patients. A research collaboration between investigators from the Robert H. Lurie Comprehensive Cancer Center of Northwestern University and the Weinberg College of Arts & Sciences extends this research, showing that pre-transplant emotional support is a predictor of survival after controlling for other demographic and medical factors known to impact survival in this population. The findings were published in Bone Marrow Transplantation.

The study involved chart reviews of 400  patients prior to undergoing HSCT. Social case worker notes were reviewed and coded by independent reviewers for self-reported perceived emotional support received by the patient prior to transplant. Higher ratings of good emotional support pre-transplant predicted longer overall survival and were marginally associated with lower rates of treatment-related mortality over a two-year period.

“This study demonstrates the important role of social workers who meet with patients pre-treatment,” said first author Katherine Ehrlich, PhD. Ehrlich was a postdoctoral fellow in the Northwestern Institute for Policy Research and the Department of Psychology, Weinberg College of Arts and Sciences, and is now Assistant Professor in Psychology at the University of Georgia. “Our findings suggest that these social workers may be in a unique position to identify patients who could benefit from additional social and emotional support to assist in their recovery throughout and following treatment.”

“These findings contribute to a growing literature documenting the favorable effects of social support and other psychosocial factors on health outcomes in cancer patients and future work should evaluate behavioral and physiological mechanisms via which social support can impact disease activity and progression,” said senior author Frank Penedo, PhD, Roswell Park Professor in Medical Social Sciences, Psychology and Psychiatry and Behavioral Sciences at Northwestern University Feinberg School of Medicine. Penedo is the leader of the Cancer Control and Survivorship Research Program and director of Cancer Survivorship and the Cancer Survivorship Institute at the Lurie Cancer Center.

“Hematopoietic Stem Cell Transplantation is a potentially a life-saving treatment for many types of blood cancers. However, this treatment also carries a significant risk for psychosocial stress for patients and their caregivers,” said oncologist John Galvin, MD, MPH, Instructor in Medicine-Hematology/Oncology at Feinberg. “This study clearly demonstrates the protective effects of emotional support for HSCT patients and, therefore, emphasizes the need to provide social interventions when needed to maximize the potential of HSCT.”

(Last updated on August 29, 2016 )