Risk of Depression and Anxiety Post Allogenic Hematopoietic Stem Cell Transplant in Pediatric Patients With Hematological Malignancies

BACKGROUND: Allogeneic Hematopoietic Stem Cell Transplant (allo-HSCT) has improved survival among hematological malignancies. An increased prevalence of psychiatric conditions has been reported. However, psychosocial assessment is not consistently implemented across transplant follow-up settings. PATIENTS AND METHODS: This is a prospective study of pediatric patients who underwent allo-HSCT at The Children's Cancer Hospital Egypt for hematologic malignancy from January 2018 to December 2021. Anxiety was assessed with the Spence Children's Anxiety Scale and Beck's Anxiety Inventory, while depression was assessed with the Child Depression Inventory and Beck's Depression Inventory. Based on the scores of these tests we grouped the patients into two categories: Absent/mild (A/M) and moderate/severe (M/S) for both depression and anxiety. RESULTS: A total of 140 patients were included. The prevalence of M/S anxiety was 35% (27/77) and M/S depression 60% (39/65) in the whole cohort. 32% of patients had both M/S anxiety and depression. Younger age at transplantation was the only factor significantly associated with M/S anxiety (p value 0.037), with increasing likelihood of anxiety with younger age at HSCT. For depression, diagnosis was the only risk factor identified. Patients with acute myeloid leukemia (AML) had a higher prevalence of depression compared to those with other diagnoses. CONCLUSION: Anxiety and depression were common among pediatric allo-HSCT survivors. These findings support incorporating routine psychological assessment into long-term follow-up, particularly for children transplanted at a younger age and those with AML.