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Associations among depression, antidepressants, survival and quality of life in hematopoietic cell transplant recipients

Bone Marrow Transplantation volume 55, pages 1868–1871 (2020)Cite this article

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Depression is a significant problem among hematopoietic cell transplant (HCT) recipients. Approximately 15% of patients meet criteria for clinically-significant depressive symptomatology before transplant, 37% in the week after transplant, and 13% during long-term survivorship [1, 2]. In contrast, the prevalence of current depression in the general U.S. population is 9% [3]. Depression is associated with worse concurrent quality of life (QOL) [1] and is inconsistently associated with worse overall survival (OS) [4,5,6]. Mixed evidence may be due to the fact that previous literature has not taken antidepressant usage into consideration. Thus, this study examined the association of pre-transplant depression and antidepressant usage with HCT outcomes, specifically concurrent physical function and OS. Four groups of HCT recipients were examined: (1) not depressed/taking antidepressants (treated depression), (2) depressed/taking antidepressants (undertreated depression), (3) depressed/not taking antidepressants (untreated depression), and (4) not depressed/not taking antidepressants (control). We hypothesized that patients with untreated and undertreated depression would demonstrate worse concurrent physical functioning and OS.

This retrospective study identified all adult English-speaking patients (≥18-year-old) diagnosed with hematologic cancer who received an HCT at Moffitt Cancer Center and completed pre-transplant questionnaires between 2011 and 2015. All participants provided informed consent. The study was approved by the University of South Florida Institutional Review Board.

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Acknowledgements

This work has been supported in part by the Biostatistics Core Facility at the H. Lee Moffitt Cancer Center & Research Institute, an NCI designated Comprehensive Cancer Center (P30-CA076292). AE-J is a scholar in clinical research of the Leukemia and Lymphoma Society.

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Authors and Affiliations

  1. II-B & José Carreras Leukemia Research Institute, Barcelona, Spain

    Anna Barata

  2. Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA

    Anna Barata, Brian D. Gonzalez, Aasha I. Hoogland, Margaret Booth-Jones & Heather S. L. Jim

  3. Department of Biostatistics and Bioinformatics, Moffitt Cancer Center, Tampa, FL, USA

    Jun-Min Zhou & Jongphil Kim

  4. Department of Hematology/Oncology Massachusetts General Hospital, Boston, MA, USA

    Areej El-Jawahri

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  1. Anna Barata
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Correspondence to Heather S. L. Jim.

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Conflict of interest

HSLJ has served as a consultant for RedHill BioPharma, Janssen Scientific Affairs and Merck. AB, BDG, JMZ, JK, AIH, AE-J, and MBJ declare no competing financial interests.

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Barata, A., Gonzalez, B.D., Zhou, JM. et al. Associations among depression, antidepressants, survival and quality of life in hematopoietic cell transplant recipients. Bone Marrow Transplant 55, 1868–1871 (2020). https://doi.org/10.1038/s41409-020-0937-y

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