Over one-third of adult survivors of bone marrow stem cell transplantation (BMT/SCT) in the treatment of cancer experience clinically significant psychological distress. Symptoms include: anxiety, depression, intrusive thoughts, and sleep disturbances. The goal of the proposed research is to improve long term adjustment in survivors of traditional and mini/light BMT/SCT.
Specific aims are to: 1) Test the efficacy of a ten-session cognitive-behavioral intervention (CBT-BMT/SCT) on cancer-specific anxiety, psychological distress, and quality of life concerns among BMT/SCT survivors; 2) Explore the influence of patient and medical factors on the impact of CBT-BMT/SCT; and 3) Investigate barriers to participation in CBTBMT/ SCT. Cancer survivors who received either traditional or mini/light BMT/SCT (one - two years prior) will be recruited from three sites (Memorial Sloan-Kettering, M.D. Anderson, and Mount Sinai) and will be randomly assigned to CBT-BMT/SCT or to a usual care control condition. Participants in both groups will be assessed before, during and after (1 week, 3 months and 6 months) the CBT-BMT/SCT group's intervention. CBT-BMT/SCT will include: 1) Education regarding problems associated with BMT/SCT survivorship, 2) Training in relaxation skills and systematic desensitization, 3) Coaching in cognitive coping skills, and 4) Facilitating enlistment of helpful social support . The impact of the intervention will be assessed using standardized measures of anxiety, distress and quality of life. Analyses will also be conducted to determine the contribution of six factors (sociodemographic variables, treatment expectancies, life events, social support/social constraints, global meaning and medical factors such as type of transplantation) to the impact of CBT-BMT/SCT. Barriers to participation in CBT-BMT/SCT (e.g., initial level of cancer specificanxiety and distress, and physician's recommendation) will also be investigated. Once the clinical utility of CBT-BMT/SCT is established, the manualized intervention can be disseminated to those responsible for the care of BMT/SCT survivors. The proposed study will be the first investigation of its kind with BMT/SCT survivors and directly addresses the NCI research priority areas outlined in NCI's 2001 Progress Review Group Report on Leukemia/Lymphoma/Myeloma.

National Institute of Health (NIH)
National Cancer Institute (NCI)
Research Project (R01)
Project #
Application #
Study Section
Special Emphasis Panel (ZRG1-RPHB-2 (01))
Program Officer
Aziz, Noreen M
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
Mount Sinai School of Medicine
Internal Medicine/Medicine
Schools of Medicine
New York
United States
Zip Code
Nenova, Maria; DuHamel, Katherine; Zemon, Vance et al. (2013) Posttraumatic growth, social support, and social constraint in hematopoietic stem cell transplant survivors. Psychooncology 22:195-202
Applebaum, Allison J; DuHamel, Katherine N; Winkel, Gary et al. (2012) Therapeutic alliance in telephone-administered cognitive-behavioral therapy for hematopoietic stem cell transplant survivors. J Consult Clin Psychol 80:811-6
Mosher, Catherine E; Lepore, Stephen J; Wu, Lisa et al. (2012) Social correlates of distress following hematopoietic stem cell transplantation: exploring the role of loneliness and cognitive processing. J Health Psychol 17:1022-32
Wu, Lisa M; Austin, Jane; Hamilton, Jada G et al. (2012) Self-efficacy beliefs mediate the relationship between subjective cognitive functioning and physical and mental well-being after hematopoietic stem cell transplant. Psychooncology 21:1175-84
Mosher, Catherine E; DuHamel, Katherine N; Rini, Christine et al. (2011) Quality of life concerns and depression among hematopoietic stem cell transplant survivors. Support Care Cancer 19:1357-65
Rini, Christine; Redd, William H; Austin, Jane et al. (2011) Effectiveness of partner social support predicts enduring psychological distress after hematopoietic stem cell transplantation. J Consult Clin Psychol 79:64-74
Mosher, C E; DuHamel, K N; Rini, C M et al. (2010) Barriers to mental health service use among hematopoietic SCT survivors. Bone Marrow Transplant 45:570-9
DuHamel, Katherine N; Mosher, Catherine E; Winkel, Gary et al. (2010) Randomized clinical trial of telephone-administered cognitive-behavioral therapy to reduce post-traumatic stress disorder and distress symptoms after hematopoietic stem-cell transplantation. J Clin Oncol 28:3754-61
Mosher, Catherine E; Redd, William H; Rini, Christine M et al. (2009) Physical, psychological, and social sequelae following hematopoietic stem cell transplantation: a review of the literature. Psychooncology 18:113-27