Post-traumatic stress disorder found in mothers whose children receive a bone marrow transplant

November 13, 2000

PHILADELPHIA (November 14, 2000) -- Preliminary results of a new study show ten percent of mothers whose children undergo bone marrow transplants (BMT) suffer from post-traumatic stress disorder (PTSD) six months after the procedure. The study will be presented November 17, 2000 at the International Conference of Behavioral Medicine in Brisbane, Australia by Fox Chase Cancer Center psychologist Sharon L. Manne, Ph.D.

The use of bone marrow transplants for children with cancer and autoimmune disorders has increased significantly over the last decade. BMT is now the standard therapy for most high-risk leukemias and is the preferred option after a leukemic relapse. Technical improvements have also led to the increased use of bone marrow transplants.

However, the significant risks of this procedure can be overwhelming for some mothers. The rate of graft rejection and possible death can be as high as 50 percent for some patients. Bone marrow transplants can also create opportunities for serious infections and recurrence of the malignancy is a possibility.

"Regardless of the advancements in this area of treatment, this is a traumatic event for any parent," says Manne. "The lengthy hospitalization, numerous treatment side effects and long-term medical risks, and ongoing fear of a cancer relapse or recurrence can lead to difficulties with emotional adjustment after the transplant."

Manne says classic symptoms of PTSD are found in some mothers.

"Mothers who have recurrent dreams about the child's transplant, re-experience traumatic memories associated with the transplant during the day, have frequent and persistent worries about the child, experience symptoms of emotional numbness, and have persistent difficulty sleeping or trouble concentrating may be suffering from post-traumatic stress disorder."

The study assesses mothers at five key points: before the transplant and at three, six, 12 and 18 months after the transplant. At the time the preliminary data was gathered, 76 of 136 mothers had completed the six-month follow-up.

"Not only is PTSD seen after the transplant, but mothers may experience considerable emotional distress before the procedure," says Manne. "This could be attributed to the demanding pre-transplant regimen which involves a lengthy hospital stay."

Manne says that identifying predictors of PTSD is an important goal of the study. "We have already identified some predictors of maternal PTSD. Mothers who have experienced a significant stressful life event prior to the BMT, have depressive symptoms prior to the BMT or increased levels of negative expectations about the outcome prior to the BMT, are at greater risk to develop PTSD."

Of the mothers who reported PTSD symptoms, most suffered from intrusion, characterized by recurrent and distressing dreams, feelings as though the event were recurring and intense distress when reminded of the event.

The second most common symptom of PTSD suffered by mothers was increased arousal characterized by the inability to sleep, outbursts of anger or difficulty concentrating.

"This type of study is key to developing new ways to help mothers who are undergoing such a traumatic lifetime event," explains Manne. "By identifying the predictors of PTSD, we can develop ways to intervene and reduce the likelihood that mother will develop PTSD."
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Collaborators on Manne's research include the Mt. Sinai Hospital, Memorial Sloan-Kettering Cancer Center, Northwestern University Medical Center, Dana-Farber Cancer Institute, Emory University Medical Center and Stanford University School of Medicine.

Fox Chase Cancer Center, one of the nation's first comprehensive cancer centers designated by the National Cancer Institute in 1974, conducts basic and clinical research; programs of prevention, detection and treatment of cancer; and community outreach. For more information about Fox Chase activities, visit the Center's web site at http://www.fccc.edu.

Fox Chase Cancer Center

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