Complementary therapies for children undergoing stem cell transplantation

Abstract

BACKGROUND: Children undergoing stem cell transplant (SCT) experience high levels of somatic distress and mood disturbance. This trial evaluated the efficacy of complementary therapies (massage, humor therapy, relaxation/imagery) for reducing distress associated with pediatric SCT. METHODS: Across 4 sites, 178 pediatric patients scheduled to undergo SCT were randomized to a child-targeted intervention involving massage and humor therapy, the identical child intervention plus a parent intervention involving massage and relaxation/imagery, or standard care. Randomization was stratified by site, age, and type of transplant. The interventions began at admission and continued through SCT Week þ3. Primary outcomes included patient and parent reports of somatic distress and mood disturbance obtained weekly from admission through Week þ6 using the Behavioral, Affective, and Somatic Experiences Scales. Secondary outcomes included length of hospitalization, time to engraftment, and usage of narcotic analgesic and antiemetic medications. RESULTS: A mixed model approach was used to assess longitudinal trends of patient and parent report outcomes and to test differences between groups on these measures. Significant changes across time were observed on all patient and parent report outcomes. However, no significant differences between treatment arms were found on the primary outcomes. Similarly, no significant between-group differences were noted on any of the medical variables as secondary outcomes. CONCLUSIONS: Results of this multisite trial failed to document significant benefits of complementary interventions in the pediatric SCT setting. Cancer 2010;116:3924-33.

Adjustment in Parents of Children Undergoing Stem Cell Transplantation

“…A detailed Consort diagram has been previously reported. 14 Descriptive statistics for demographic and medical variables are presented in Table 1. In summary, no significant differences were found among intervention arms on any of the medical (i.e., site, type of transplant, diagnostic group), or demographic (i.e., child age, child gender, child race/ethnicity, resident parent) variables.…”

“…The effects of the intervention on child outcomes have been previously reported. 14,15 This report focuses on parental outcomes. We hypothesized that parents who receive this health-promotion intervention (in addition to their child’s intervention) during the acute phase of their child’s SCT will show decreased emotional distress and increased positive adjustment in comparison to parents in the child-targeted arm of the intervention or those receiving only standard care.…”

Resilience in Children Undergoing Stem Cell Transplantation: Results of a Complementary Intervention Trial

“…This is consistent with the previously reported findings from this same trial regarding acute distress during the in-patient transplantation period. 29 The lack of significant results can be better appreciated in the context of 2 findings that may be more noteworthy than the null intervention effects. First is the significant improvement over time on all outcomes across all patient groups, including those receiving only SC.…”

“…More detail regarding the patients and a Consort flow diagram was provided in an earlier report. 29 For the outcomes presented here, there was an evaluable sample of 163 at baseline and 97 at week+24. A total of 25 patients died, 11 withdrew, 8 were taken off study for medical reasons (relapse, second transplant), and 22 missed the week +24 assessment.…”

“…The effects of the intervention on the acute distress experienced by patients during transplant hospitalization have been previously reported. 29 This article presents findings regarding the efficacy of these interventions on longer-term outcomes of psychological adjustment, HRQL, and benefit finding at 6 months after transplantation.…”