SYMPTOM DISTRESS, COPING STYLE AND BIOLOGICAL VARIABLES AS PREDICTORSOF SURVIVAL AFTER BONE-MARROW TRANSPLANTATION

Psychological assessments made at the time of bone marrow transplantat ion (BMT) were examined in 31 patients at 1-2 years posttransplantatio n and factors associated with survival were explored. Psychological as sessments were carried out soon after admission to hospital for the BM T and about 3-4 weeks later. Cox regression survival analysis revealed that an interactive biopsychological model could explain survival sta tus. Shorter survival was associated with mismatched marrow grafts (p= 0.04), prior experience with chemoradiotherapy (p=0.02), disease stage (p=0.04), higher symptom distress during BMT (p=0.008), less hopefuln ess (p=0.005), and more acceptance of the situation (p=0.02). These ps ychological/psychosomatic and personality characteristics may act dire ctly by inter acting with immune function or indirectly by leading to other behaviors known to affect survival in cancer patients. Enhancing more effective coping strategies and altering high symptom-related di stress during BMT seem important means not only for improving psychoso cial adjustment (quality of life) as has been shown in the literature, but also for increasing survival (quantity of life). (C) 1997 Elsevie r Science Inc.