ANXIETY AS A POSSIBLE PREDICTOR OF ACUTE GVHD

In order to determine the influence of anxiety on the development of B MT complications and survival, we analysed data on 35 consecutive pati ents undergoing BMT in our Centre between June 1992 and December 1994, All patients received bone marrow from HLA-identical MLC non-responsi ve siblings, For GVHD prophylaxis, all patients received cyclosporin ( CsA) and short methotrexate (MTX), The diagnosis and severity of acute GVHD were defined according to the Seattle Transplant Team criteria, The patients were tested with the Spielberger STAI test as a measure o f anxiety as a state (STAL-S) and as a trait (STAI-T), The STAI-S/1 an d STAI-T/1 were performed during the first week of isolation (day -5 t o day -3 prior BMT) and STAI-S/2 and STAI-T/2 at the end of the discha rge from laminar air pow units (day +35 to day +40 post-transplant), D uring isolation all patients had daily psychiatric support, Out of 35 patients, 31 (89%) fulfilled the STAI-S and STAI-T during the first we ek and at discharge from laminar air flow isolation, The level of anxi ety at the beginning of isolation as measured by STAI-S/1 and STAI-T/1 tests had been significantly higher in patients who subsequently deve loped acute grade II-IV GVHD as compared to patients with GVHD grade 0 -I (P < 0.001), irrespective of age, sex or stage of the disease prior to BMT, In those patients who died, the STAI-S/1, STAI-T/1 and STAI-T /2 tests had been almost identical to those of surviving patients, whi le STAI-S/2 had been significantly higher (P = 0.034), These data clea rly indicate an association between the level of anxiety and the risk for BMT complications, but this should be confirmed in further control led clinical trials.