PO.CL11.02 · 临床研究

血液或骨髓移植长期生存者所报告的自杀意念：一项BMTSS报告

Suicidal ideation endorsed by long-term survivors of blood or marrow transplantation: A BMTSS report

编号 1229 展板 3 时间 4/19 02:00–05:00 区域 Section 48 主讲 Ritika Samant, BS;MPH

分会场 Survivorship, Supportive Care, and Quality of Life in Oncology

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作者与单位 Authors & Affiliations

Ritika R. Samant¹, Devika Bhatia², Qingrui Meng¹, Yanjun Chen¹, Lindsey Hageman¹, Liton Francisco¹, Sarah Palmer¹, Eunice Choe¹, Nora Balas¹, Alysia Bosworth³, Ravi Bhatia¹, Lennie Wong³, Daniel Weisdorf⁴, Wendy Landier¹, Saro Armenian³, Smita Bhatia¹

¹University of Alabama at Birmingham, Birmingham, AL,²University of Colorado, Denver, CO,³City of Hope, Duarte, CA,⁴University of Minnesota, Minneapolis, MN

摘要 Abstract

中文摘要

背景：高强度治疗暴露和长期免疫抑制使血液或骨髓移植（BMT）生存者面临更高的长期躯体和心理并发症风险，而这可能导致生存者出现自杀意念。方法：我们对1974年至2014年间在三家移植中心之一（希望之城、明尼苏达大学或阿拉巴马大学伯明翰分校）接受自体或异体BMT并在BMT后存活≥2年的BMT生存者进行了自杀意念研究。本分析共纳入3,841名BMT生存者和1,261名同胞，他们均在年龄≥18岁时完成了一份包含255个条目的调查问卷。该问卷评估社会人口学特征、慢性健康状况和心理健康。结果：总体而言，5.7%的BMT生存者和3.1%的同胞报告了自杀意念。与同胞相比，BMT生存者报告自杀意念的比值高出1.9倍（95%CI=1.34–2.68，p值=0.003）。在对调查时年龄、性别、收入、保险、重度/危及生命的慢性健康状况、疼痛和抑郁进行校正的多变量分析中，BMT生存者与同胞之间自杀意念的差异被削弱（OR=1.04；95%CI=0.71–1.53，p=0.84）。将分析限制于BMT生存者时，我们发现研究时年龄较小（18–34岁：OR=2.2，95%CI=1.4–3.6，p=0.002；参照：年龄>65岁）、收入较低（<$75,000：OR=1.43，95%CI=1.0–2.0；参照：≥$75,000，p=0.04）、抑郁（OR=9.81，95%CI=7.2–13.4）和疼痛（OR=1.65，95%CI=1.2–2.3，p=0.002）与自杀意念相关。结论：疼痛、抑郁和慢性健康状况的较高患病率解释了BMT生存者相较于同胞报告自杀意念的较高比值。收入较低、伴有抑郁和疼痛的BMT生存者报告自杀意念的风险最高。这些发现提示，需要对高危BMT生存者加强对自杀意念的监测和干预。

查看英文原文 English abstract

Background: High intensity therapeutic exposures and prolonged immune suppression place blood or marrow transplant (BMT) survivors at a higher risk of long-term physical and psychological morbidity that could lead to suicidal ideation endorsed by survivors. Methods: We examined suicidal ideation in BMT survivors who received autologous or allogeneic BMT between 1974 and 2014 at one of three transplant programs (City of Hope, University of Minnesota, or University of Alabama at Birmingham) and survived ≥2y after BMT. Overall, 3,841 BMT survivors and 1,261 siblings completed a 255-item survey at age ≥18y were included in this analysis. The survey assesses sociodemographics, chronic health conditions, and psychological health. Results: Overall, 5.7% of the BMT survivors and 3.1% of the siblings reported suicidal ideation. BMT survivors were at a 1.9-fold greater odds of endorsing suicidal ideation compared with siblings (95%CI=1.34-2.68, p-value=0.003). Multivariable analysis adjusting for age at survey, sex, income, and insurance, severe/life-threatening chronic health conditions, pain, and depression to the model, mitigated the difference in suicidal ideation between BMT survivors and siblings (OR=1.04; 95%CI=0.71-1.53, p=0.84). Restricting the analysis to BMT survivors, we found that younger age at study (18-34y: OR=2.2, 95%CI=1.4-3.6, p=0.002; reference: age >65y), lower income (<$75,000: OR=1.43, 95%CI=1.0-2.0; reference: ≥$75,000, p=0.04), depression (OR=9.81, 95%CI=7.2-13.4), and pain (OR=1.65, 95%CI=1.2-2.3, p=0.002) were associated with suicidal ideation. Conclusions: The higher prevalence of pain, depression, and chronic health conditions explain the higher odds of suicidal ideation endorsed by BMT survivors compared with siblings. BMT survivors with lower income, depression and pain are at the highest risk of endorsing suicidal ideation. These findings suggest a need for increased surveillance and intervention for suicidal ideation among at-risk BMT survivors.

利益披露 Disclosure

R. R. Samant, None.. D. Bhatia, None.. Q. Meng, None.. Y. Chen, None.. L. Hageman, None.. L. Francisco, None.. S. Palmer, None.. E. Choe, None.. N. Balas, None.. A. Bosworth, None.. R. Bhatia, None.. L. Wong, None.. D. Weisdorf, None.. W. Landier, None.. S. Armenian, None.

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