Depression/Antidepressant Use Associated With QOL but not OS in Patients With Hematologic Malignancies Undergoing HSCT, Study Finds

No considerable affiliation in between melancholy or antidepressant use and all round survival (OS) was noticed for clients with hematologic malignancies undergoing hematopoietic stem cell transplantation (HSCT), according to the effects of a retrospective analyze posted in Bone Marrow Transplantation.

Better
premiums of clinically major despair have been noticed for HSCT
recipients as opposed with the basic US populace. Despite the fact that the optimum fees
of despair for those people going through HSCT have been claimed in the week pursuing
this treatment, write-up-HSCT prices of melancholy have been shown to keep on being
persistently elevated in this patient population relative to the US populace
command team.

Even though
before scientific tests have shown an association among depression and diminished
good quality of existence (QOL) in the setting of HSCT, conflicting evidence pertaining to
whether or not or not HSCT has a detrimental effect on OS may possibly be relevant to a failure
to consider into account antidepressant use in people research.

In this study, demographic and clinical info were
abstracted from the health-related information of a cohort of 1797 adult patients with
different hematologic malignancies who underwent HSCT at a solitary, significant
educational oncology centre. At the time of pretransplant vital organ tests
(VOT), 2 validated measures, the Client
Health and fitness Questionnaire-8 (PHQ-8) and the Clinical Outcomes Analyze Limited Kind
(SF-12), ended up applied
to assess depression and wellbeing-linked QOL, respectively, in this individual
group. In addition, antidepressant use was assessed amongst VOT and 3 weeks
subsequent HSCT.

Hematologic
malignancies diagnosed in this client cohort incorporated acute myeloid leukemia
(AML 22%), several myeloma/amyloidosis (40%), myeloproliferative neoplasm
(MPN)/myelodysplasia (10%), lymphoma (27%), other (1%).

Of the 703 individuals undergoing allogeneic
transplantation, 54%, 26%, 15%, 3%, and 2% experienced a diagnosis of AML,
MPN/myelodysplasia, lymphoma, multiple myeloma/amyloidosis, and other,
respectively. With regards to the 1094 patients dealt with with autologous
transplantation, approximately two-thirds had a number of myeloma/amyloidosis and close to
one-third had lymphoma.

Separate analyses were being carried out for those
undergoing allogeneic and autologous HSCT. People going through these strategies
have been categorised as belonging to 1 of 4 teams: 1) addressed melancholy, described
as not depressed/using antidepressants 2) undertreated melancholy, defined as
depressed/having antidepressants 3) untreated melancholy, described as depressed/not
using antidepressants and 4) regulate, outlined as not depressed/not using
antidepressants.

The percentages of individuals in the allogeneic
HSCT subgroup categorised as belonging to teams 1 through 4 were being 21%, 7%, 7%,
and 65%, respectively, whereas 18%, 7%, 8%, and 67% in the autologous HSCT
subgroup have been categorized into the respective groups.

On multivariable
analyses managing for Karnofsky performance standing, regimen depth, and time from analysis to HSCT, melancholy/antidepressant use was proven to be
independently associated with bodily functioning in both those undergoing
allogeneic and autologous HSCT (P
<.05). In both transplantation subgroups, those with treated depression had better physical functioning than those with undertreated or untreated depression, but worse physical functioning compared with the control group.  

However,
multivariable analyses taking into account European Bone Marrow Transplant
(EBMT) risk score did not show a significant association between
depression/antidepressant use and OS for those undergoing either allogeneic or
autologous HSCT.

Limitations
of this study included the absence of data on the indication for antidepressant
use (eg, depression, pain), as well as any psychosocial care received. In
addition, patients were not evaluated for depression during the peritransplant
period.

The study authors noted that these results “lend support for integrated psychosocial care in the allogeneic
and autologous setting.”

Reference

Barata A, Gonzalez BD, Zhou JM, et al. Associations among depression, antidepressants, survival and quality of life in hematopoietic cell transplant recipients [published online May 12, 2020]. Bone Marrow Transplant. doi: 10.1038/s41409-020-0937-y



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