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Peritransplant Psychiatric Evaluation of Patients With Fanconi Anemia

Kearney, Julia A. MD; Hay, Jennifer L. PhD; Halpern, Lauren BA; Boulad, Farid MD

Journal of Pediatric Hematology/Oncology: April 2012 - Volume 34 - Issue 3 - p 163–168
doi: 10.1097/MPH.0b013e31824c9623
Original Articles

Patients with Fanconi anemia (FA) referred for stem cell transplantation (SCT) have multiple psychosocial risk factors and often present in distress in the peritransplant period. Twenty-two patients with FA were referred for psychiatry consultation before, during, or after SCT, across a 13-year period at Memorial Sloan-Kettering Cancer Center. The most common diagnoses were mood (50%), adjustment (46%), and anxiety (23%) disorders and delirium (23%); the most common psychiatric symptoms were anxious/depressed (86%), withdrawn (64%), and aggressive (59%) symptoms. Etiology of the diagnoses and symptoms included: chronic childhood illness, physical and/or neurodevelopmental disability, presence of a genetic syndrome, presence of a cancer predisposition syndrome, exposure to therapeutic androgens, and exposure to pediatric SCT. However, the degree of influence of the different factors could not be determined. In addition, other factors such as impact of sibling illness or loss, extent of treatment nonadherence, level and significance of neurodevelopmental pathologies were identified. Future prospective and possibly multicenter studies will need to be generated for a better understanding and more complete factor analysis.

Departments of *Psychiatry and Behavioral Sciences

Pediatrics, Memorial Sloan-Kettering Cancer Center, New York, NY

The authors declare no conflict of interest.

Reprints: Julia A. Kearney, MD, Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, 641 Lexington Avenue, Seventh Floor, New York, NY 10022 (e-mail: kearneyj@mskcc.org).

Received January 14, 2011

Accepted October 24, 2011

Copyright © 2012 Wolters Kluwer Health, Inc. All rights reserved.