How Do Patients Cope When Undergoing HSCT?

By Richard Newcomb, MD - Last Updated: February 26, 2024

Richard Newcomb, MD, a Bone Marrow Transplant Physician at Massachusetts General Hospital, discussed a study on coping in patients with hematologic malignancies undergoing hematopoietic stem cell transplantation (HSCT).

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“The first thing we did was show that patients really do truly use a variety of coping mechanisms,” Dr. Newcomb began. “What was interesting is that many patients are using more than one approach-oriented coping technique.”

In a data set of approximately 300 patients, over 60% practice emotional support and acceptance, while about 33% practice self-blame, and 31% practice denial. Approximately 25% of patients use more than one avoidant-coping method, and approximately 10% of patients use both approach-oriented and avoidant coping.

According to Dr. Newcomb, approach-oriented coping was associated with higher quality of life and lower symptoms of depression and anxiety prior to transplant. Meanwhile, avoidant coping was associated with decreased quality of life and increased symptoms of depression, anxiety, and post-traumatic stress disorder.

“In patients that use both approach- and avoidant-oriented coping, the signal toward increased distress was still present,” Dr. Newcomb explained. “It seems that using avoidant-coping is potentially a marker for increased risk of psychological distress.”

Dr. Newcomb and colleagues also found that age, gender, and higher income affect patient coping mechanisms. Specifically, female gender and being on disability prior to transplant were associated with a higher use of avoidant-coping.

“In future studies we need to look at longitudinal assessment of coping after transplant and figure out interventions to support approach-oriented coping and mitigate avoidant-coping, as that can have the potential to improve quality of life and reduce psychological distress,” Dr. Newcomb said.

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