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ORIGINAL RESEARCH article

Front. Immunol.
Sec. Autoimmune and Autoinflammatory Disorders : Autoimmune Disorders
Volume 15 - 2024 | doi: 10.3389/fimmu.2024.1436639

Psychological impact of autologous hematopoietic stem cell transplantation in systemic sclerosis patients and influence of resilience

Provisionally accepted
Marc Schmalzing Marc Schmalzing 1*Michael Gernert Michael Gernert 1Matthias Fröhlich Matthias Fröhlich 1Jörg Henes Jörg Henes 2Nathalie Schwindl Nathalie Schwindl 3Leona Zerhusen Leona Zerhusen 3Lukas Berthold Lukas Berthold 1Johannes Hewig Johannes Hewig 3Andrea Kübler Andrea Kübler 3Ann-Christin Pecher Ann-Christin Pecher 2Sonja Kleih-Dahms Sonja Kleih-Dahms 3Patrick-Pascal Strunz Patrick-Pascal Strunz 1Philipp Ziebell Philipp Ziebell 3
  • 1 Department of Medicine II, Rheumatology and Clinical Immunology, University Hospital of Würzburg, Würzburg, Germany
  • 2 Department of Internal Medicine II, University Hospital Tübingen, University of Tübingen, Tübingen, Germany
  • 3 Institute for Psychology, Faculty of Human Sciences, Julius Maximilian University of Würzburg, Würzburg, Bavaria, Germany

The final, formatted version of the article will be published soon.

    Objective: In severe cases of systemic sclerosis (SSc), autologous hematopoietic stem cell transplantation (aHSCT) is superior compared to cyclophosphamide. But treatment related morbidity and mortality have to be considered. To date, data on major physical and psychological impacts of aHSCT are scarce. Therefore, subjectively experienced physical and psychological impact of aHSCT and exploration of internal and external factors helping to cope with aHSCT was assessed.Methods: Retrospective assessment of physical and psychological variables in an SSc cohort after aHSCT to describe: Health-related quality of life (HRQL), SSc-associated impairment, coping strategies, body image, and resilience. Additionally, semi-structured interviews were conducted and analysed via mixed methods qualitative content analysis.Results: Thirty-two patients were included. HRQL correlated with impairment due to SSc and with depressive coping. An unfavourable body image correlated with reduced HRQL and increased impairment but improves after aHSCT. Patients with good resilience had a better HRQL, less depressive coping, and less SSc-associated impairment. The semi-structured interviews revealed that resilience is important for a successful disease management as patients with higher resilience were more satisfied with aHSCT, patients with lower resilience would have wished for more psychological support. Thirty-one patients would recommend aHSCT to other patients.A transient negative impact of aHSCT on mental well-being is present but can be relieved by a team specialised to aHSCT. Psychological support seems to be an unmet need, particularly in patients with low resilience. Patients with higher resilience described a lower negative impact caused by aHSCT and higher satisfaction after therapy.

    Keywords: systemic sclerosis, Psychological impact, Autologous hematopoietic stem cell transplantation, resilience, Immunosupression

    Received: 22 May 2024; Accepted: 10 Oct 2024.

    Copyright: © 2024 Schmalzing, Gernert, Fröhlich, Henes, Schwindl, Zerhusen, Berthold, Hewig, Kübler, Pecher, Kleih-Dahms, Strunz and Ziebell. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Marc Schmalzing, Department of Medicine II, Rheumatology and Clinical Immunology, University Hospital of Würzburg, Würzburg, Germany

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