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QoL and Patients' Care

Depression and anxiety following hematopoietic stem cell transplantation: a prospective population-based study in Germany


In this prospective multicenter study, we investigated the course of depression and anxiety during hematopoietic stem cell transplantation (HSCT) until 5 years after transplantation adjusting for medical information. Patients were consulted before HSCT (n=239), at 3 months (n=150), 12 months (n=102) and 5 years (n=45) after HSCT. Depression and anxiety were assessed with the Hospital Anxiety and Depression Scale (HADS). Detailed medical and demographic information was collected. Prevalence rates were compared with an age- and gender-matched control group drawn from a large representative sample (n=4110). The risk of depression before HSCT was lower for patients than for the control group (risk ratio (RR), 0.56; 95% confidence interval (CI), 0.39/0.81). Prevalence rates of depression increased from 12 to 30% until 5 years post HSCT. Anxiety rates were most frequently increased before HSCT (29%, RR, 1.31; 95% CI, 1.02/1.68) and then reached a stable level comparable to the background population (RR 0.83, 95% CI, 0.56/1.22). This study confirms the low levels of depression in the short term after HSCT and identifies depression as a long-term effect. Furthermore, it confirms previous results of heightened anxiety before HSCT. Surveillance of symptoms of anxiety during the short-term phase of HSCT and of depression during the following years is crucial.

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This work was supported by the José Carreras Leukämie-Stiftung (grants DJCLS R 04/29pf, DJCLS R 07/37pf and DJCLS R 10/38p).

Author contributions

AS, LS, AS, LS and MK performed the research. AS, AM, UK, FS-K and AZ designed the research study. AZ and NK contributed essential reagents or tools. KK and PE analyzed the data. All authors wrote the paper.

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Correspondence to K Kuba.

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Kuba, K., Esser, P., Mehnert, A. et al. Depression and anxiety following hematopoietic stem cell transplantation: a prospective population-based study in Germany. Bone Marrow Transplant 52, 1651–1657 (2017).

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