Repercussões na saúde mental dos sobreviventes ao transplante de células tronco hematopoiéticas para tratamento do câncer hematológico na infância e na adolescência: revisão sistemática da literatura.

• Autor(a) principal: Cunha, Rachel Silva Menezes da
• Data de Publicação: 2016
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Biblioteca Digital de Teses e Dissertações da UERJ
• Texto Completo: http://www.bdtd.uerj.br/handle/1/4415
• topic: Mental health; Hematologic neoplasms; Hematopoietic stem cell transplantation; Infantile-juvenile cancer; Survivors; Systematic review; Saúde mental; Neoplasias hematológicas; Transplante de célula tronco hematopoiética; Câncer infanto-juvenil; Sobreviventes; Revisão sistemática; CNPQ::CIENCIAS DA SAUDE::SAUDE COLETIVA::EPIDEMIOLOGIA

Hematopoietic stem cell transplantation (HSCT) is a modality of oncological treatment associated with considerable levels of morbidity. In a setting where patients survive for longer periods of time, attention has been paid to the late sequelae of this procedure. The present systematic review aims to compile the published information on the prevalence of mental disorders among survivors of HSCT for the treatment of hematological and lymphoid neoplasms in childhood and adolescence, as well as the possible factors associated with the occurrence of these disorders. We used 13 databases to search publications from 1990 to January 2016. After applying inclusion and exclusion criteria, eight articles were selected for review. A total of 8449 individuals were studied, including 1009 survivors of HSCT. The mean age at diagnosis ranged from 5 to 9 years and subjects were assessed from 1 to 16 years after diagnosis. The mental health outcomes studied were the psychological and mental domains of quality of life (QoL), depression, behavioral disorders, self-esteem, and hyperkinetic disorders, behavior, social functioning, eating and sleep, being used nine different instruments for evaluation. Among the results found, it is observed that the outcomes tend to be more unfavorable when the parents are the respondents of the questionnaires compared to those in which the patients themselves respond. The results also tend to be worse when patients are already adults, when compared to the evaluation performed in childhood or adolescence, and less favorable when the transplant population is compared to the general population, with less significant differences when this comparison with non-transplanted patients. Late physical effects, intensity of treatment on the Central Nervous System (CNS) and maternal depression were recognized as possible explanatory variables for changes in the mental health of survivors. As for the quality of the articles, the majority received less than two thirds of the Newcastle - Ottawa Quality Assessment Scale. The present study presents limitations imposed by the scarce number of articles and the methodological differences of the studies on the subject. The heterogeneity of the studies did not allow meta-analysis. However, this review is the first to group previously published knowledge on the mental health of survivors of HSCT in childhood and adolescence as part of the treatment for hematological and lymphoid neoplasms. Its results lead to the recognition of the importance of this theme, as well as to the gaps that still exist. As these neoplasms are the most frequent among children and adolescents, with increasing rates of survival, it is necessary to think about the possible underreporting of these consequences. The tracking of mental sequelae in the long-term follow-up of this population could bring to the surface a more reliable picture of the mental repercussions that both the disease and its aggressive treatment with HSCT can generate.