Results of a large-scale study comparing adults with and without diagnosed depression prior to hematopoietic cell transplantation (HCT) found that those with pre-HCT depression had significantly lower survival and a higher incidence of grade II-IV acute GVHD. Researchers analyzed outcomes of 7,433 allogeneic transplants between 2008 and 2012 that were reported to CIBMTR (Center for International Blood and Marrow Transplant Research).
Data from patient medical charts indicated that 15% (n=1,116) of the patients had pre-transplant depression requiring treatment. A multivariate analysis showed that these patients had significantly higher overall mortality (HR 1.13, 95% CI 1.04-1.23, p=0.004) and higher risk of grade II-IV acute GVHD (HR 1.25, 95%CI 1.14-1.37, p<0.0001), but similar risk of chronic GVHD (HR 1.06, 95% CI 0.96-1.16, p=0.26). The researchers concluded that patients with pre-HCT depression “represent a highly vulnerable population at risk for post-transplant mortality and complications, and they may benefit from more intensive medical and psychological interventions.”
El-Jawahri A, et al. Biol Blood Marrow Transplant