Palliative Care Improves Quality of Life for Bone Marrow Transplant Patients
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DURHAM, N.C. -- Palliative care -- relief from symptoms -- significantly improves a patient’s quality of life and eases fatigue, depression and post-traumatic stress symptoms while they are hospitalized for bone marrow transplant.
The findings of a clinical trial co-led by Duke Health researchers were presented during the American Academy of Hospice and Palliative Medicine conference on March 23.
“Patients undergoing hematopoietic stem cell transplantation face a significant burden of treatment-related symptoms and issues that lead to impaired quality of life and reduced function,” said co-investigator Thomas LeBlanc, M.D., a hematologic oncologist and chief patient experience and safety officer for the Duke Cancer Institute. “Standard transplant care may not optimally address these patient-experience issues.”
Researchers tested the effectiveness of an integrated palliative care intervention across diverse settings. They enrolled 360 adults undergoing bone marrow transplants at three academic medical centers, including Duke University Hospital, Massachusetts General Hospital and the Fred Hutch Cancer Center at the University of Washington.
Half of the adults received usual care. The other half met with a palliative care clinician at least twice a week during their transplant hospitalization to monitor symptom management, quality of life, depression, anxiety, fatigue, coping, and PTSD symptoms.
Patients receiving the palliative care intervention reported better quality of life, defined by the degree to which an individual is healthy, comfortable, and able to participate in life events. They also had lower depression, PTSD and fatigue symptoms compared to those receiving usual care.
Anxiety did not differ significantly between the two groups of patients; however, the caregivers of patients receiving palliative care had reduced anxiety symptoms. The inpatient palliative care intervention also led to improved PTSD symptoms six months after transplant.
“Integrated specialist palliative care yielded impressive improvements in the patient and caregiver experience of stem cell transplantation,” Leblanc said. “This should be considered a new standard of care.”
Additional study investigators include Yi-bin Chen, Zachariah Defilipp, Areej El-Jawahri, Chris Jones, Betsy Fricklas, James Fausto, Joseph Greer, Vicki Jackson, Alison Kavanaugh, Stephanie Lee, Jennifer Temel, Lara Traeger and Jason Webb.
The clinical trial received funding support from the National Cancer Institute (R01 grant) and the Leukemia and Lymphoma Society.