Colloque

Psychological factors correlate with survival after bone marrow transplantation

Lawrence Hoffman

Nadia Szkrumelak

A. K. Sullivan

Membre a labase

Lawrence Hoffman

Résumé du colloque

Evidence from both human and animal studies indicates that stress influence the hypothalamic pituitary axis and modifics immune function, but the mechanisms that link psychodynamic factors to physologic responses remain largely unknown. The study was designed to explore possible relationships between life long personality traits and the response to a major therapeutic stress using bone marrow transplantation as a model. From 1984 to October, 1993, 114 patients underwent a pre-transplant psychiatric evaluation. Three areas of functioning were assessed prospectively: 1) Family dynamics; 2) Individual psychological maturity 3) Transplantation construct. Each component was assigned a value from 1 ("LOW") to 3 ("HIGH") with a total between 3 and 9 (the "F.I.T. score"). By one year after transplant, > 90% of the "LOW" group had died whereas > 90% of the "HIGH" group remained alive. When data were analyzed according to source of marrow class of disease or phase of the program differences between the two groups remained. These data suggest that personality structure could either influence directly, or be surrogates for other factors that influence the ability of an individual to survive 2-12 months after bone marrow transplantation. Although these psychological parameters appear to predict survival better than any physiologic measurement described to date, further work will be necessary to document the reproductibility of the evaluation methods, and to correlate the "F.I.T." score" with other cell biologic mechanisms.