Psychological impact of autologous hematopoietic stem cell transplantation in systemic sclerosis patients and influence of resilience.

Autor:	Schmalzing M; Department of Internal Medicine 2, Rheumatology/Clinical Immunology, University Hospital Würzburg, Würzburg, Germany., Gernert M; Department of Internal Medicine 2, Rheumatology/Clinical Immunology, University Hospital Würzburg, Würzburg, Germany., Fröhlich M; Department of Internal Medicine 2, Rheumatology/Clinical Immunology, University Hospital Würzburg, Würzburg, Germany., Henes J; Centre for Interdisciplinary Clinical Immunology, Rheumatology and Auto-inflammatory Diseases and Department of Internal Medicine II (Oncology, Hematology, Immunology, Rheumatology), University Hospital Tübingen, Tübingen, Germany., Schwindl N; Institute of Psychology, University of Würzburg, Würzburg, Germany., Zerhusen L; Institute of Psychology, University of Würzburg, Würzburg, Germany., Berthold L; Department of Internal Medicine 2, Rheumatology/Clinical Immunology, University Hospital Würzburg, Würzburg, Germany., Hewig J; Institute of Psychology, University of Würzburg, Würzburg, Germany., Kübler A; Institute of Psychology, University of Würzburg, Würzburg, Germany., Pecher AC; Centre for Interdisciplinary Clinical Immunology, Rheumatology and Auto-inflammatory Diseases and Department of Internal Medicine II (Oncology, Hematology, Immunology, Rheumatology), University Hospital Tübingen, Tübingen, Germany., Kleih-Dahms S; Institute of Psychology, University of Würzburg, Würzburg, Germany., Strunz PP; Department of Internal Medicine 2, Rheumatology/Clinical Immunology, University Hospital Würzburg, Würzburg, Germany., Ziebell P; Institute of Psychology, University of Würzburg, Würzburg, Germany.
Jazyk:	angličtina
Zdroj:	Frontiers in immunology [Front Immunol] 2024 Oct 24; Vol. 15, pp. 1436639. Date of Electronic Publication: 2024 Oct 24 (Print Publication: 2024).
DOI:	10.3389/fimmu.2024.1436639
Abstrakt:	Objective: In severe cases of systemic sclerosis (SSc), autologous hematopoietic stem cell transplantation (aHSCT) is superior compared to cyclophosphamide. But treatment related morbidity and mortality have to be considered. To date, data on major physical and psychological impacts of aHSCT are scarce. Therefore, subjectively experienced physical and psychological impact of aHSCT and exploration of internal and external factors helping to cope with aHSCT was assessed. Methods: Retrospective assessment of physical and psychological variables in an SSc cohort after aHSCT to describe: Health-related quality of life (HRQL), SSc-associated impairment, coping strategies, body image, and resilience. Additionally, semi-structured interviews were conducted and analyzed via mixed methods qualitative content analysis. Results: Thirty-two patients were included. HRQL correlated with impairment due to SSc and with depressive coping. An unfavorable body image correlated with reduced HRQL and increased impairment but improves after aHSCT. Patients with good resilience had a better HRQL, less depressive coping, and less SSc-associated impairment. The semi-structured interviews revealed that resilience is important for a successful disease management as patients with higher resilience were more satisfied with aHSCT, patients with lower resilience would have wished for more psychological support. Thirty-one patients would recommend aHSCT to other patients. Conclusion: A transient negative impact of aHSCT on mental well-being is present but can be relieved by a team specialized to aHSCT. Psychological support seems to be an unmet need, particularly in patients with low resilience. Patients with higher resilience described a lower negative impact caused by aHSCT and higher satisfaction after therapy. Competing Interests: MS received speaker’s fees, travel grants, research funding, or compensation for consultancies or board memberships from AbbVie, Actelion, AstraZeneca, BMS, Boehringer/Ingelheim, Celgene, Chugai/Roche, Eli Lilly, Genzyme, Gilead, Hexal/Sandoz, Janssen-Cilag, MSD, Novartis, Pfizer, Sanofi Pasteur, Takeda Shire, UCB. MG received travel grants, compensation for advisory boards or speaker’s fees from AbbVie, Amgen, AstraZeneca, Eli Lilly, Hexal, Janssen, Novartis, Pfizer, Takeda, UCB. MF received speaker’s fees, travel grants or compensation for board memberships from AbbVie, Novartis, Janssen, and Eli Lilly. JHen received an unrestricted grant from NEOVII. P-PS received speaker’s fees and travel grants from Janssen-Cilag Galapagos, Eli Lilly, Boehringer/Ingelheim and AbbVie less than $10,000 each. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2024 Schmalzing, Gernert, Fröhlich, Henes, Schwindl, Zerhusen, Berthold, Hewig, Kübler, Pecher, Kleih-Dahms, Strunz and Ziebell.)
Databáze:	MEDLINE
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