Psychobiologische Prädiktoren des Behandlungsoutcomes nach allogener Stammzelltransplantation
No Thumbnail Available
Files
Date
2025-09-30
Authors
Publisher
item.page.supervisor-of-thesis
Abstract
Allogeneic stem cell transplantation represents an essential therapeutic option for various
hematopoietic neoplasms. Over the past decades, success rates have improved, and new
conditioning regimens have expanded the patient population. Molecular genetic insights
contribute increasingly to a better understanding, precise risk stratification, and more ac-
curate therapy. Nevertheless, the physical and psychological burdens of this still-risky
procedure remain significant, with low success rates compared to other oncological con-
ditions.
While many predictors for the success of allo-HSCT have been extensively researched,
the data on psychobiological factors such as age, activity, and depression are limited.
To address this, the P-POST study was conceived as a pilot study to measure the influence
of psychobiological parameters on the outcomes of allo-HSCT. Between December 2020
and December 2021, 42 patients from the Department of Hematology and Oncology at
UKGM Marburg were recruited and examined at four time points (T0: Before HSCT, T1:
10-15 days after HSCT, T2: discharge from the hospital, T3: six months after HSCT)
from the start of conditioning therapy. This work is based on a subset of the data, exam-
ining the impact of depression, physical activity and patient age at the beginning of the
study on the clinical course, measured by the timing of engraftment, the occurrence of
severe adverse events, graft-versus-host disease (GvHD) cases, the number of relapses
and mortality, quality of life and depression after allo-HSCT. Within a six-month obser-
vation interval, the study cohort decreased to 30 patients due to mortality.
Psychometric assessments utilized the PHQ-9 (depressiveness), IPAQ (activity), and
FACT-LEU questionnaire (quality of life). The FACT-LEU-TOI (treatment-related sub-
scale) was additionally considered. Bivariate correlations were used for statistical corre-
lation models, with results considered statistically significant at p < 0.05.
A higher level of reported depressiveness (M = 6.53, SD = 4.98) at the beginning of the
transplantation process predicted a lower global quality of life six months after allo-HSCT
(r = -0.456, p = 0.038, n = 21) but had no impact on other defined endpoints. Similarly,
there was no statistically significant impact of increased subjectively reported physica
94
activity (M = 4290.3, SD = 4242.68) on the course of allo-HSCT, both in terms of clinical
endpoints and quality of life six months post-transplantation. Notably, addressing this
hypothesis was challenging due to low compliance,
However, a higher age at the beginning of allo-HSCT (M = 57.7, SD = 10) proved to be
a predictor of a better treatment-related (r = 0.495, p = 0.016, n = 23) and global quality
of life (r = 0.449, p = 0.036, n = 22), as well as lower perceived depressiveness (r = -
0.562, p = 0.005, n = 23) six months after allogeneic stem cell transplantation.
Although the significance of this pilot study is limited by a small sample size, it provides
new hypotheses for future studies. Furthermore, it emphasizes the impact of, contrary to
findings of known retrospective studies, even subclinical depressiveness on the quality of
life after allo-HSCT and contributes to negating the use of mere age limits in the indica-
tion for allo-HSCT. In contrast to the assumption that older patients suffer more from
allo-HSCT, this work identifies younger patients as a risk group for an adverse psycho-
oncological course of allo-HSCT and outlines the need for careful support for this group.
The study also highlights the necessity to consider and to reduce obstacles to patient com-
pliance, when designing studies that implement psychometric surveys.
In the end, among the many approaches investigated, the detrimental impact of increasing
depressiveness on the quality of life six months after allo-HSCT proved to be as signifi-
cant as the favorable influence of higher age on depressiveness and quality of life six
months after allo-HSCT.
Review
Metadata
Contributors
Dates
Issued: 2025-09-30
Faculty
FB20:Medizin
Language
de
Keywords
Stammzelltransplantationallo-HSZTDepressivitätstem cell transplantationdepressionactivityAktivitätLeukämie
show more
Lishewski, Philipp: Psychobiologische Prädiktoren des Behandlungsoutcomes nach allogener Stammzelltransplantation. : 2025-09-30.
License
Except where otherwised noted, this item's license is described as Attribution-NonCommercial-NoDerivs 3.0 Germany