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Physician-diagnosed depression and suicides in pediatric hematopoietic cell transplant survivors with up to 40 years of follow-up

Bone Marrow Transplantation volume 51, pages 153–156 (2016)Cite this article

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Although childhood hematopoietic cell transplantation (HCT) survivors often experience acute psychological effects,1 very little is known about their long-term mental health. In a previous quality-of-life study of our long-term childhood HCT survivors, depression assessed on standardized self-reported measures was higher in patients compared with sibling controls2 suggesting that depression may be an important psychological complication, but specific information is lacking. Among childhood cancer survivors, the prevalence of depression ranges from 5 to 30%3, 4, 5, 6 and depression has been associated with female gender,5, 6 cranial irradiation5 and obesity.4 In childhood HCT survivors, the prevalence of depression is largely unknown with one retrospective study reporting 12% of survivors having unspecified signs of depression7 and depression has been associated with prednisone,8 female gender2 and the amount of therapy received before transplant.2 Childhood and young adult cancer survivors are also more likely than controls to use antidepressants.9, 10 The purpose of this retrospective study was to determine the prevalence and identify risk factors for physician-diagnosed depression or suicide in childhood HCT patients.

Between 1969 and 1 January 2011, 1122 consecutive children <18 years of age received conditioning therapy and survived at least 2 years after HCT at the Fred Hutchinson Cancer Research Center (FHCRC), Seattle, WA, USA. Excluded from the analysis were 18 patients who did not consent to follow-up or who were incarcerated, 14 with depression diagnosed before referral for transplantation, and 6 with metabolic disorders that could predispose them to depression. The remaining 1084 patients or their responsible guardians consented to follow-up and data were reviewed under a protocol approved by the FHCRC Institutional Review Board.

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Acknowledgements

Supported in part by the National Cancer Institute (CA 018029, HL 36444, CA 15704, CA 160684 and CA 78902). We are thankful to the FHCRC Long-term Follow-up staff and to our patients and their physicians who participate in our long-term follow-up program.

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Authors and Affiliations

  1. Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA

    P A Hoffmeister, B E Storer, K L Syrjala & K S Baker

  2. Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, USA

    K S Baker

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  1. P A Hoffmeister
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  2. B E Storer
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  3. K L Syrjala
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  4. K S Baker
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Correspondence to K S Baker.

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Hoffmeister, P., Storer, B., Syrjala, K. et al. Physician-diagnosed depression and suicides in pediatric hematopoietic cell transplant survivors with up to 40 years of follow-up. Bone Marrow Transplant 51, 153–156 (2016). https://doi.org/10.1038/bmt.2015.233

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