Related Experiment Video
Updated: Mar 20, 2026
Detection of Residual Donor Erythroid Progenitor Cells after Hematopoietic Stem Cell Transplantation for Patients with Hemoglobinopathies
Published on: September 6, 2017
Pilot Study of Parent Psychophysiologic Outcomes in Pediatric Hematopoietic Stem Cell Transplantation
Jessica Ward1, Barbara Swanson, Louis Fogg
1Author Affiliations: College of Nursing, Rush University, Chicago, Illinois (Drs Swanson and Fogg and Ms Ward); and School of Nursing, Duke University, Durham, North Carolina (Dr Rodgers).
Insights
Parents of children undergoing hematopoietic stem cell transplantation (HSCT) experience increased stress and decreased T-lymphocyte counts. This study demonstrates the feasibility of monitoring these psychophysiological changes longitudinally in the HSCT setting.
Area of Science:
- Psychoneuroimmunology
- Pediatric Oncology
- Transplantation Medicine
Background:
- Parents of children undergoing hematopoietic stem cell transplantation (HSCT) are susceptible to psychological distress.
- This distress can manifest in physiological changes, including immune, inflammatory, or endocrine effects, which have not been previously documented.
- Understanding these psychophysiological responses is crucial for supporting families during this challenging period.
Purpose of the Study:
- To assess the feasibility of longitudinally measuring psychophysiological stress indicators in parents of pediatric patients undergoing HSCT.
- To identify potential correlations between parental stress and physiological markers throughout the transplantation process.
Main Methods:
- A pilot study involving parents of children undergoing HSCT at a Midwest children's hospital.
- Longitudinal data collection at multiple time points: pre-HSCT conditioning, and days +30, +60, and +100 post-transplant.
- Assessment of parent-perceived stress, lymphocyte subsets (CD3+ T-lymphocytes), C-reactive protein (CRP), proinflammatory cytokines, salivary cortisol, and salivary amylase.
Main Results:
- Twelve parent-child dyads participated, with minimal missing data.
- Significant increases in parent-perceived stress and concurrent decreases in CD3+ T-lymphocyte counts were observed from pre-HSCT through day +100.
- No significant changes were detected in salivary cortisol, salivary amylase, CRP, or proinflammatory cytokines.
Conclusions:
- Longitudinal measurement of psychophysiological outcomes in parents of pediatric HSCT patients is feasible.
- Parental stress increases linearly throughout the HSCT process, accompanied by a decrease in T-lymphocyte counts.
- These findings highlight the need for routine psychological screening and psychosocial support for parents during pediatric HSCT.
Background:
Parents of children undergoing hematopoietic stem cell transplantation (HSCT) are at risk for psychological distress. This distress may result in aberrant immune, inflammatory, or endocrine effects. These physiologic outcomes have not been reported previously.
Main Objective:
The aim of this study is to examine the feasibility of longitudinal testing of psychophysiological parameters of stress in parents of children undergoing HSCT.
Methods:
This pilot study was conducted at a large children's hospital in the Midwest and included parents of children who received autologous or allogeneic HSCT. Time points included before the start of HSCT conditioning and day +30, +60, and +100. Outcome variables included parent-perceived stress, lymphocyte subsets, C-reactive protein (CRP), proinflammatory cytokines, salivary cortisol, and salivary amylase. Effect sizes were calculated for each outcome.
Results:
Twelve parent-child dyads were enrolled (10 mothers, 2 fathers). Missing data were minimal. Parent-perceived stress significantly increased from pre-HSCT through day +100, and parent CD3+ T-lymphocyte counts decreased from pre-HSCT through day +100. No significant effects were observed for salivary studies, CRP, or proinflammatory cytokines. Effect sizes ranged from 1.23 (perceived stress) to 0.07 (CRP).
Conclusion:
The results of this study suggest that it is feasible longitudinally measure parent psychophysiologic outcomes in the pediatric HSCT setting. In addition, parent-perceived stress increased linearly from start of conditioning through day +100, whereas parent T-lymphocyte counts decreased concurrently.
Implications For Practice:
Routine psychological and physical health screening of parents of children undergoing HSCT is needed. Multidisciplinary psychosocial support services should be offered to parents at regular intervals during their child's HSCT.
