This proposal will support the research and further the applicant's training as a behavioral scientist in cancer prevention and control. Dr. Costanzo's goals are to examine contributions of psychosocial factors to cancer outcomes, to elucidate biobehavioral mechanisms underlying these relationships, and to ultimately translate these findings into targeted behavioral interventions for individuals with cancer. To achieve these aims, a didactic plan focused on the development of: 1) a stronger conceptual grounding in cancer biology and behavioral immunology, and 2) more sophisticated methodological skills including immune assay techniques and advanced analytical strategies, will complement Dr. Costanzo's background in clinical and health psychology. Training objectives will be accomplished through targeted coursework and multidisciplinary mentorship in the context of the comprehensive scholarly resources available at the University of Wisconsin School of Medicine and Public Health. The research plan will utilize knowledge and new techniques learned to investigate novel hypotheses regarding the extent to which mood disturbance can influence the recovery of innate and adaptive immunity following hematopoietic stem cell transplantation (HSCT) and thereby alter clinical outcomes. Adults with hematologic malignancies receiving autologous or allogeneic transplants at the University of Wisconsin Carbone Comprehensive Cancer Center will be evaluated pre-transplant, with a focus on mood disturbance and potential cognitive mediators of mood, including avoidance of unwanted private experiences and capacity to find meaning in this challenging life experience. Follow-up psychological, immune, and biomedical assessments will occur 30, 100, and 200 days post-transplant. The first study of autologous transplant recipients will utilize novel multicolor flow cytometry and immunophenotyping techniques to delineate leukocyte reconstitution following transplant. A second study focused on allogeneic transplant recipients will track inflammatory processes, including systemic cytokine levels, and the development of graft-versus-host disease. This research would be the first prospective examination of psychosocial influences on post-transplant recovery and is designed to set the stage for the applicant to develop, and ultimately test, an evidence-based psychosocial intervention with the potential to meaningfully improve post-transplant outcomes and quality of life. Dr. Costanzo will focus the final years of the award on obtaining training in the design of clinical trials and developing a behavioral intervention tailored to the needs of HSCT recipients. At the end of the award period, Dr. Costanzo will be well-poised to extend her research in several novel directions with clear translational relevance as a fully independent investigator in cancer prevention and control.
The goal of this research is to examine the impact of psychological factors on the recovery of cancer patients after stem cell transplantation (HSCT). Both risk factors, including mood disturbance, as well as potentially protective factors, such as ability to find meaning, will be evaluated prospectively in transplant patients with the aim of determining how these factors impair or facilitate immune recovery and are associated with clinical complications. The research is a critical step in designing interventions and psychological services that will improve survival and enhance the quality of life of cancer survivors recovering from HSCT.
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