Associations between coping and survival time of adult leukemia patients receiving allogeneic bone marrow transplantation - Results of a prospective study

Background: To investigate associations between coping strategies and lengt h of survival in a sample of 52 adult leukemia patients receiving allogenei c bone marrow transplantation (BMT). Methods: 52 adult patients, diagnosed with acute (AML) and chronic myeloid leukemia (CML) admitted for allogeneic BMT to a university hospital BMT unit in preparation for a transplantation of genotypically matched HLA donor marrow, were interviewed immediately af ter informed consent and prior to preparatory treatment for transplantation . Semistructured interviews were conducted and recorded for analysis to ass ess coping styles and were evaluated by a new content analytic coping measu re [Ulm Coping Manual (UCM)]. Patients were a random sample of all eligible patients on the BMT unit between May 1990 and May 1994. Results: Complete audiotaped interviews were rated by blind raters, employing a newly develop ed content analysis for the identification of patients' coping strategies. Multivariate analysis using a Cox model revealed three pretransplant variab les that demonstrated a statistically significant influence on 5-year survi val: Stage of Disease at transplant (P < .012), Distraction (P < .007), and Fighting Spirit as coping modalities (P < .013). Conclusions: The results of this prospective study document the impact of certain psychological vari ables, notably coping style on survival with BMT. This suggests the necessi ty of utilizing psychosocial interventions to address stress and anxiety in patients awaiting transplantation in order to reduce anxieties and to empl oy more effective coping techniques to deal more appropriately with their s ituation and to enhance Fighting Spirit. The effects on survival of such ps ychosocial interventions need to be tested in a randomized controlled study . (C) 2001 Elsevier Science Inc. All rights reserved.