Suicidal Ideation Experienced by Long-Term Survivors of Blood or Marrow Transplantation: A Blood or Marrow Transplant Survivor Study Report.

High-intensity therapeutic exposures and prolonged immune suppression place blood or marrow transplant (BMT) survivors at a high risk of long-term physical and psychological morbidity that could lead to suicidal ideation. We examined suicidal ideation in BMT survivors who received autologous or allogeneic BMT between 1974 and 2014 at one of three transplant programs and survived ≥2 y after BMT. Overall, 3841 BMT survivors and 1261 siblings who completed a 255-item survey at age ≥18 y were included. The survey assesses sociodemographics, chronic health conditions, and psychological health. BMT survivors were at a 1.9-fold greater odds of experiencing suicidal ideation compared with siblings (95% CI = 1.34 to 2.68). Multivariable analysis adjusting for age at survey, sex, income, insurance, marital status, severe/life-threatening chronic health conditions, pain, anxiety, and depression, mitigated the difference in suicidal ideation between BMT survivors and siblings (OR = 0.97; 95% CI = 0.65 to 1.44). Restricting the analysis to BMT survivors, we found that, male sex (OR = 1.38, 95% CI = 1.02 to 1.87), being divorced (OR = 1.74, 95% CI = 1.13 to 2.67; reference: married), presence of anxiety (OR = 2.32, 95% CI = 1.66 to 3.26), and presence of both pain and depression (OR = 10.67, 95% CI = 6.71 to 16.97; reference: no depression or pain) were associated with suicidal ideation. These findings suggest a need for increased surveillance and intervention for suicidal ideation among at-risk BMT survivors.