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      Posttraumatic stress symptoms predict impaired neutrophil recovery in stem cell transplant recipients

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          Abstract

          Objective

          Despite the potentially life-saving effects of stem cell transplant (SCT), many transplant patients experience traumatic stress reactions due to mortality threat, interpersonal isolation, financial and occupational loss, and invasive medical procedures. Emerging evidence suggests that traumarelated stress symptoms (TSS) predict significant health complications following SCT. The aim of the current prospective study was to examine TSS in the acute aftermath of SCT as a predictor of neutrophil recovery following SCT, a crucial component of immune defense against infection.

          Methods

          Fifty-one autologous SCT recipients were assessed for TSS 7 days after SCT. Patients’ absolute neutrophil counts were collected from medical charts for the first 30 days following SCT. Hierarchical linear growth modeling was used to test the hypothesis that TSS at day 7 would be associated with delayed recovery of neutrophil counts from days 9 to 30 post SCT, that is, when neutrophil counts began to recover.

          Results

          As hypothesized, TSS measured 7 days after SCT was significantly associated with slower neutrophil recovery even after pre-existing TSS, depression, distress related to physical symptoms, and potential medical confounds were statistically controlled. Exploratory analyses showed that of the TSS symptom clusters, re-experiencing symptoms and hyperarousal symptoms predicted neutrophil recovery, whereas avoidance symptoms did not.

          Conclusion

          Though traumatic stress symptoms may be a normative response to SCT, our findings suggest that TSS following SCT may interfere with neutrophil recovery and overall health. These results provide further insight as to potential mechanisms by which traumatic stress translates to poor medical outcomes for SCT patients.

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          Author and article information

          Journal
          9214524
          20586
          Psychooncology
          Psychooncology
          Psycho-oncology
          1057-9249
          1099-1611
          15 June 2015
          27 January 2015
          November 2015
          01 November 2016
          : 24
          : 11
          : 1529-1535
          Affiliations
          [1 ]Department of Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
          [2 ]Department of Psychiatry, Rush University Medical Center, Chicago, IL, USA
          [3 ]Cancer Treatment Centers of America, Philadelphia, PA, USA
          [4 ]The Coleman Foundation Blood and Bone Marrow Transplant Program, Rush University Medical Center, Chicago, IL, USA
          [5 ]Department of Medical Oncology, Fox Chase Cancer Center, Philadelphia, PA, USA
          Author notes
          Correspondence to: Department of Behavioral Sciences, Rush University Medical Center, 1645W. Jackson Blvd, Suite 400, Chicago, IL 60612, USA. Stevan_Hobfoll@ 123456rush.edu
          Article
          PMC4516698 PMC4516698 4516698 nihpa700455
          10.1002/pon.3761
          4516698
          25628257
          4e060f83-ef39-4e35-aa18-893ee7a3b7aa
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