PSYCHOSOCIAL FACTORS PREDICTIVE OF SURVIVAL AFTER ALLOGENEIC BONE-MARROW TRANSPLANTATION FOR LEUKEMIA

Previous research suggesting a link between psychosocial variables and survival after bone marrow transplant (BMT) has been limited by: a) r etrospective assessment of psychosocial variables; and b) failure to c oncurrently examine a comprehensive set of disease, treatment, and dem ographic variables potentially related to post-BMT survival. The prese nt study prospectively assessed psychosocial variables (depressed mood , functional quality of life, and mental adjustment to cancer) that ha ve been linked to survival after BMT and/or malignant disease. Study p articipants (N = 42) received allogeneic BMT for either acute or chron ic leukemia, Analyses using Cox proportional hazards regression indica ted that quality of bone marrow graft match was the only disease, trea tment, or demographic variable significantly associated with post-BMT survival (p = .05). Addition of psychosocial variables to a multivaria te Cox regression model including quality of graft match suggested tha t an attitude toward cancer characterized by ''anxious preoccupation'' (p = .008), as well as poorer functional quality of life (p = .052), were each independently associated with poorer post-BMT survival. Furt her research is necessary to identify the mechanisms by which psychoso cial variables could contribute to post-PMT survival.