Poster & Mini-oral COSA 2015 ASM

 Fear of cancer recurrence post allogeneic hematopoietic stem cell transplant for malignant disease: Adapting to the ‘new normal’.  (#166)

Lisa Brice 1 , Nicole Gilroy 2 , Gemma Dyer 2 3 , Masura Kabir 4 , Matthew Greenwood 1 5 , Stephen Larsen 6 , John Moore 7 , Mark Hertzberg 8 , John Kwan 8 , Louisa Brown 9 , Gillian Huang 8 , Jeff Tan 7 , Chris Ward 1 5 , Ian Kerridge 1 5
  1. Royal North Shore Hospital, St Leonards, NSW, Australia
  2. Blood and Marrow Transplant Network, NSW Agency for Clinical Innovation, Sydney, NSW, Australia
  3. Northern Clinical School, Faculty of Medicine, University of Sydney, Sydney, NSW, Australia
  4. Westmead Breast Cancer Institute, Sydney, NSW, Australia
  5. Northern Blood Research Centre, Kolling Institute, University of Sydney, Sydney, NSW, Australia
  6. Department of Haematology, Royal Prince Alfred Hospital, Sydney, NSW, Australia
  7. Department of Haematology, St Vincents Hospital, Sydney, NSW, Australia
  8. Department of Haematology, Westmead Hospital, Sydney, NSW, Australia
  9. Department of Haematology, Newcastle Mater Hospital, Sydney, NSW, Australia

Aims: The aim of this cross sectional study was to identify psychosocial, medical and sociodemographic variables that impact Fear of Cancer Recurrence (FoCR) in patients who were >1 year post allogeneic Hematopoietic Stem Cell Transplantation (HSCT).

Method: A total of 1,475 Allogeneic BMT were performed in the study period.  Of the 669 recipients known to be alive at study sampling, 583 were contactable and were sent study packs.   Four hundred and forty three returned the completed survey.  Three percent declined participation and patients with a non-malignant diagnosis pre transplant were excluded from the analysis. Participants included three hundred and sixty five patients who had undergone HSCT for a malignant disease. Participants completed a number of questionnaires, which assessed FoCR, psychological functioning, quality of life, demographic, social and clinical variables.

Results: Predictors significantly associated with FoCR included employment (p=0.01), skin cancer (p=0.01), depression (p=0.005), anxiety (p=0.003), health screening (pap smear) (p=0.003), referral to a psychiatrist (p=0.003) and in those taking psychotropic medication (p=0.02). A stepwise regression using a p value threshold of 0.10 for model retention, determined that the variables most strongly associated with FoCR were Quality of Life (QoL) (Beta=-0.10, p<0.0001) years since transplant (Beta=-0.19, p=0.02), being in first or second remission at transplant (Beta=-1.38, p=0.02) and marital status (Beta=1.32, p=0.06).

Conclusions: Establishing the key predictors of FoCR will provide important information to develop education and support programs pre and post HSCT. Models of Care for post HSCT follow-up should include a patients assessment of their FoCR so that health professionals can initiate candid discussions about FoCR that balance realistic recurrence risks and the debilitating impact of unrealistic fear about cancer recurrence.