OBJECTIVES: The primary aim of this study was to examine the impact of patient sense of coherence (SOC) on anxiety and depressive symptoms, and quality of life (QoL) dimensions in the acute phase of haematopoietic stem cell transplantation (HSCT). A secondary aim was to determine if SOC measured pre-transplant was predictive of psychological distress and QoL post-transplantation, after controlling for physical wellbeing. METHOD: A series of measures was completed by 60 HSCT patients prior to transplantation. Follow-up data were collected at 2-3 weeks and 3 months post-transplantation. Measures administered included the Brief Symptom Inventory-18, Orientation to Life Questionnaire, and Functional Assessment of Cancer Therapy-Bone Marrow Transplantation. RESULTS: When compared across the three time points, depression levels, and physical and functional wellbeing were worst at 2-3 weeks post-transplantation. SOC was positively associated with physical wellbeing prior to HSCT but not after transplantation. Weaker SOC predicted higher levels of depression, and poorer social, emotional, and functional wellbeing at both follow-up points, after accounting for physical wellbeing. CONCLUSIONS: Given that SOC was related to depression and QoL dimensions post-transplantation, it may be important for health care professionals to conduct psychosocial assessments to determine patient SOC. This would enable provision of tailored psychological support prior to and following stem cell transplantation.