When is the best time for psychotherapeutic intervention following autologous peripheral blood stem cell transplantation

Background and objective: To compare the impact of (A) an earlier (months 1 to 6 after PBSCT) vs. (B) a later (months 6 to 12) individualised psychodynamic short-time psychotherapy on health related quality of life. Design and methods: Psychotherapy focused on coping and relevant elements of the patient's history. It used guided imagery. One hundred and seventy-nine of 194 eligible patients were randomly assigned to the arms A (n = 88) and B (n = 91). Fifteen patients participated in data survey only. All patients filled in the EORTC Questionnaire Core 30 and the Profile of Mood States (POMS). Results: Sixty patients (36 A, 24 B) completed psychotherapy. In comparison with B-completers, A-completers showed significantly higher pre/post psychotherapy improvements in the following EORTC QLQ-C30 subscales: Global Health Score (empirical effect size d =.97; p =.001), Role Function (d =.84; p =.004), Fatigue (d =.74; p =.01). Furthermore, A-completers scored better than B-completers in Emotional and Social Function and in POMS-Vigour (p =.32). We statistically controlled for Karnofsky performance status and illness stage. Interpretation and conclusion: Psychotherapy can enhance HRQoL more efficiently when applied sooner following PBSCT, rather than later in the survivor's time trajectory.