Influence of psychobiological predictors on the outcome of patients after allogeneic hematopoietic stem cell transplantation

INTRODUCTION: Allogeneic hematopoietic stem cell transplantation is a standard treatment for hematologic diseases. While biological predictors of transplant success are well established, psychobiological factors such as depression and physical activity remain underexplored. This study investigates their influence on clinical outcomes and quality of life after allogeneic hematopoietic stem cell transplantation. METHODS: In this prospective study, 42 patients undergoing transplantation (December 2020- December 2021) were assessed at four time points (T0-T3). Depression was assessed using the Patient Health Questionnaire-9, physical activity using the International Physical Activity Questionnaire, and quality of life using the Functional Assessment of Cancer Therapy-Leukemia and its Trial Outcome Index subscore. Bivariate correlations (p-value <0.05) were used to examine associations with clinical endpoints (leukocyte engraftment, GVHD, adverse events ≥ Grade III, relapse, mortality, and quality of life at six months). RESULTS: Higher depression at T0 (Mean: 6.53; SD: 4.98) predicted lower global quality of life at T3 (r = -0.46; p = 0.04), but not clinical outcomes. Physical activity at T0 (Mean: 4290.3; SD: 4242.7) showed no significant associations. Older age (Mean: 57.7; SD: 10.2) was linked to a better Trial Outcome Index (r = 0.5; p = 0.02), higher global quality of life (r = 0.45; p = 0.04), and lower depression (r = -0.56; p = 0.005) at T3. Complications had no effect on quality of life or depression. CONCLUSION: Depression before allogeneic hematopoietic stem cell transplantation may predict poorer quality of life afterward. Older age was associated with better outcomes, suggesting rigid age limits for allogeneic hematopoietic stem cell transplantation should be re-evaluated.