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Anxiety, depression, and mental health-related quality of life in survivors of pediatric allogeneic hematopoietic stem cell transplantation: a systematic review

Bone Marrow Transplantation volume 55, pages 1240–1254 (2020)Cite this article

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Abstract

Allogeneic hematopoietic stem cell transplantation (allo-HSCT) has become increasingly used as a therapeutic treatment for several pediatric conditions, however the long-term mental health sequelae remain understudied among these survivors. Our objective was to conduct a systematic literature review to determine the association between allo-HSCT and anxiety, depression, and psychological health-related quality of life (HRQOL) in pediatric allo-HSCT recipients compared to survivors of pediatric cancer or healthy children. A literature search of peer-reviewed databases was conducted. Data extraction was conducted using a standardized form. Due to the heterogeneity in studies, populations, and measurement instruments, only a qualitative synthesis was performed. A total of 24 studies met eligibility criteria. Rates of anxiety and depression were higher among survivors of pediatric allo-HSCT compared to population normal values or children treated for health conditions without allo-HSCT. Most allo-HSCT survivors self-reported psychological HRQOL within normal levels, although some studies in leukemia patients identified poorer psychological HRQOL. The presence of multiple chronic health conditions, chronic graft-versus-host-disease, and patient sex were important risk factors for worse mental health. Patients who receive allo-HSCT during childhood experience subsequent anxiety, depression, and poorer psychological HRQOL after transplant and several clinical characteristics contribute to these mental health sequelae.

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Acknowledgements

We would like to thank Thomasin Adams-Webber for her assistance with the citation searches of the electronic databases. Ms. Adams-Webber is a trained librarian with expertize in conducting searches for systematic reviews in clinical research.

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  1. These authors contributed equally: Tal Schechter, Jason D. Pole

Authors and Affiliations

  1. Pediatric Oncology Group of Ontario, Toronto, ON, Canada

    Giancarlo Di Giuseppe & Jason D. Pole

  2. Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada

    Giancarlo Di Giuseppe & Jason D. Pole

  3. Division of Hematology/Oncology, Hospital for Sick Children, Toronto, ON, Canada

    Nirav Thacker & Tal Schechter

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Di Giuseppe, G., Thacker, N., Schechter, T. et al. Anxiety, depression, and mental health-related quality of life in survivors of pediatric allogeneic hematopoietic stem cell transplantation: a systematic review. Bone Marrow Transplant 55, 1240–1254 (2020). https://doi.org/10.1038/s41409-020-0782-z

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