PSYCHOLOGICAL AND IMMUNOLOGICAL REACTIONS OF FAMILY MEMBERS TO PATIENTS UNDERGOING BONE-MARROW TRANSPLANTATION

The authors' goal was to evaluate the impacts of patients' bone marrow transplant (BMT) on their spouse/partner's (subjects) psychological a nd immunological status at four key points in the course of their tran splant. Subjects' (N = 24) psychological and immunological status was prospectively evaluated at four key points in the patient's BMT which included: at patients' admission to hospital and 0-, 20-, and 34-day i ntervals after BMT infusion. Psychological variables examined included : a) general psychological distress and negative affect; b) tendency t o respond in a socially desirable manner; c) state negative affect; an d d) coping style, specifically if escape-avoidance coping was used. I mmune variables examined included: percentages of total T cells and of CD4(+), CD8(+) cells, B cells, and natural killer (NK) cells, and NK cytoxicity, Greatest abnormality in immune variables was detected befo re the initiation of BMT (ie, between admission and day 0) with normal ization between days 21 and 34 thereafter. During the waiting period b efore BMT, the subjects had the highest scores on negative affects, es cape-avoidance coping, and psychological symptoms. These progressively declined after the BMT procedure. Significant correlations were found among trait anxiety, escape-avoidance coping, and total percentage of T cells and of CD4(+) cells. Escape-avoidance coping was reliably cor related with percentage of B cells. The greatest psychological and imm unological impacts on spouse/partners of BMT patients were found in th e period directly after hospital admission and before BMT infusion. Al terations in immune values occurred in anticipation of BMT in the spou se/partners. Psychological symptoms followed this same pattern, being most elevated before BMT and decreasing in the successive evaluations post-BMT for the spouse/partners. The most significant and consistent psychological variable in predicting immune changes was escape-avoidan ce coping, with less escape-avoidance coping predicting better immune functioning.