Fear of disease progression and relevant correlates in acute leukemia patients prior to allogeneic hematopoietic stem cell transplantation

Objective Prior to hematopoietic stem cell transplantation (HSCT), and despite the high objective risks associated with HSCT, fear of progression (FoP) has only sparsely been studied in patients with acute leukemia until now. The aim of this study was the assessment of the prevalence of FoP, and any relevant correlates and typical concerns. Methods We included 59 adult patients with acute leukemia who were tested prior to their first HSCT during an in-patient stay. Patients completed self-report measures assessing FoP (Fear of Progression Questionnaire-Short Form, FoP-Q-SF) and relevant correlates of FoP (eg, patients' physical state, depression, psychosocial distress, or social support). Results About one third of the patients (35.6%; n = 21) had high FoP. Higher FoP was associated with previous cancer diagnosis, as well as depression, anxiety, reduced physical functioning, lower mental health-related quality of life, and lower positive social support. The greatest fears reported by these patients reflected common fears of cancer patients (eg, fear about leaving their families behind), but also specific fears related to the current situation (eg, fear of severe medical treatments during the course of the illness). Conclusions This was the first study providing an extensive analysis of FoP in leukemia patients prior to the extreme situation of HSCT. FoP is frequent and of major clinical importance for these patients. Hence, we recommend that patients undergo routine screening for FoP, to identify highly distressed patients at an early stage, and to offer targeted support.