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Grant Details

Grant Number: 5R21CA133343-02 Interpret this number
Primary Investigator: Costanzo, Erin
Organization: University Of Wisconsin-Madison
Project Title: Predictors of Optimal Immune Reconstitution in Stem Cell Transplant Patients
Fiscal Year: 2011
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Abstract

DESCRIPTION (provided by applicant): Individuals undergoing hematopoietic stem cell transplantation (HSCT) face severe cancer- and treatment-related stressors and experience heightened anxiety and depressed mood, which may influence the immune recovery process following transplant, impair quality of life, and ultimately increase risk of mortality. The proposed project will investigate whether psychological status pre- and post-transplant influences the reconstitution of innate and adaptive immunity and the occurrence of opportunistic infections during the 6 months following transplant. Participants will be 75 adults receiving autologous stem cell transplants at the University of Wisconsin Comprehensive Cancer Center. They will complete pre-transplant assessments of mood disturbance, perceived stress, and social support. Follow-up psychological, immune, and clinical assessments will occur at 1 and 3 months post- transplant. Granulocytes and natural killer cells will index recovery of innate immunity, and novel multicolor flow cytometry and immunophenotyping techniques will be employed to examine the reemergence and activation of monocyte and associated dendritic cell lineages during the first month, and subsequently the profile of B and T cell subsets at 3 months. Occurrence of viral, bacterial, and fungal infections will be determined from review of clinical history and medical records. Longitudinal mixed-effects and survival modeling strategies will be applied to discern the most salient predictors and magnitude of impact on post-transplant outcomes. The purpose of the study is to determine biobehavioral pathways by which psychological factors can hinder or facilitate the immune and clinical recovery following HSCT. This study would be the first prospective examination of the psychological influences on post-transplant immune reconstitution and is designed to set the stage for the development of an evidence-based psychosocial intervention to enhance quality of life and survival of HSCT patients. PUBLIC HEALTH RELEVANCE: The primary goal of this project is to examine the impact of psychological factors on the recovery of cancer patients after stem cell transplantation (HSCT). Both risk factors, such as mood disturbance, as well as potentially protective factors, including social support, will be evaluated prospectively in transplant patients with the aim of determining how those factors impair or facilitate the immune reconstitution that is associated with clinical complications and recovery. The project is a critical initial step for designing interventions and psychological services that will improve survival and enhance the quality of life of cancer survivors recovering from HSCT.

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Publications

Illness perceptions predict health practices and mental health following hematopoietic stem cell transplantation.
Authors: Nelson A.M. , Juckett M.B. , Coe C.L. , Costanzo E.S. .
Source: Psycho-oncology, 2019 06; 28(6), p. 1252-1260.
EPub date: 2019-04-23.
PMID: 30942921
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Spirituality and the recovery of quality of life following hematopoietic stem cell transplantation.
Authors: Leeson L.A. , Nelson A.M. , Rathouz P.J. , Juckett M.B. , Coe C.L. , Caes E.W. , Costanzo E.S. .
Source: Health psychology : official journal of the Division of Health Psychology, American Psychological Association, 2015 Sep; 34(9), p. 920-8.
EPub date: 2014-12-29.
PMID: 25545043
Related Citations

Sleep quality following hematopoietic stem cell transplantation: longitudinal trajectories and biobehavioral correlates.
Authors: Nelson A.M. , Coe C.L. , Juckett M.B. , Rumble M.E. , Rathouz P.J. , Hematti P. , Costanzo E.S. .
Source: Bone marrow transplantation, 2014 Nov; 49(11), p. 1405-11.
EPub date: 2014-08-18.
PMID: 25133898
Related Citations

Biobehavioral influences on recovery following hematopoietic stem cell transplantation.
Authors: Costanzo E.S. , Juckett M.B. , Coe C.L. .
Source: Brain, behavior, and immunity, 2013 Mar; 30 Suppl, p. S68-74.
EPub date: 2012-07-20.
PMID: 22820408
Related Citations

Biobehavioral influences on cancer progression.
Authors: Costanzo E.S. , Sood A.K. , Lutgendorf S.K. .
Source: Immunology and allergy clinics of North America, 2011 Feb; 31(1), p. 109-32.
PMID: 21094927
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Psychoneuroimmunology and health psychology: an integrative model.
Authors: Lutgendorf S.K. , Costanzo E.S. .
Source: Brain, behavior, and immunity, 2003 Aug; 17(4), p. 225-32.
PMID: 12831823
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Occupational exposure to Cr(VI): comparison between chromium levels in lymphocytes, erythrocytes, and urine.
Authors: Lukanova A. , Toniolo P. , Zhitkovich A. , Nikolova V. , Panev T. , Popov T. , Taioli E. , Costa M. .
Source: International archives of occupational and environmental health, 1996; 69(1), p. 39-44.
PMID: 9017433
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