According to a study published in Psycho‐Oncology, patients with newly diagnosed malignant lymphoma or multiple myeloma who reported depressive symptoms prior to the start of chemotherapy had poorer survival compared with patients who were not initially depressed.
The prospective analysis was conducted at the Nagoya City University Hospital in Japan. Researchers sought to investigate the influence of depressive symptoms in patients with hematologic malignancies before and 1 month after the initiation of chemotherapy. The primary outcome was overall survival (OS).
Patients with newly diagnosed malignant lymphoma or multiple myeloma were enrolled between September 2010 and March 2016. Depressive symptoms were assessed at baseline before the start of chemotherapy and after 1 month using the self-reported Patient Health Questionnaire‐9 and known prognostic factors. Patients with depression were categorized according to their depressive symptoms: persistent patients were defined as having experienced persistent depressive symptoms from baseline to 1 month; new onset patients experienced new depressive symptoms at 1 month; and patients in remission experienced remission of depressive symptoms at 1 month.
Data from 255 patients were included in the analysis. In total, 83 patients experienced depression: 19 had new onset symptoms, 38 were in remission, and 26 had persistent symptoms. Overall, patients with depression had shorter OS compared with those without depression (adjusted hazard ratio [HR], 2.43; 95% CI, 1.43‐4.12; P <.001).
When using patients who never experienced depressive symptoms (172 patients) as a reference group and subdividing the depression groups, patients in the remission group (adjusted HR, 2.98; 95% CI, 1.55‐5.74; P =.001) and persistent group (adjusted HR, 2.17; 95% CI, 1.01‐4.68; P =.047) had shorter OS; however, the new-onset group did not (adjusted HR, 1.91; 95% CI, 0.77‐4.75; P =0.166).
The authors suggested that more studies are needed “to investigate the factors associated with depressive symptoms around the time of diagnosis.”
1. Hasegawa T, Okuyama T, Uchida M, et al. Depressive symptoms during the first month of chemotherapy and survival in patients with hematological malignancies: A prospective cohort study [posted online July 2, 2019]. Psycho-Oncology. doi:10.1002/pon.5143