Post-transplant psychosocial and mental health care of hematopoietic cell transplant recipients

Abstract

Receiving the diagnosis of a hematopoietic malignancy is a terrifying experience, often leading to a hematopoietic stem cell transplant (HCT) as a potentially life-saving intervention. Undergoing an HCT is an extensive, multistep process involving chemotherapy, prolonged hospitalization, and invasive medical procedures. Patients endure significant physical effects that have the potential to become chronic. Given this, all healthcare providers understand that some form or variation of psychosocial distress is inevitable. This chapter will specifically focus on the spectrum of psychiatric sequelae in the post-HCT period, including depression, anxiety, posttraumatic stress disorder, and cognitive disorders. Additionally, a review of the most common somatic symptoms, fatigue and insomnia, in the post-HCT period are also highlighted given their direct impact on quality of life. Finally, we will review the unmet mental health needs identified in the literature, evidence-based guidelines for distress management, and approaches to psychotropic medication management.