Music Therapy for Symptom Management After Autologous Stem Cell Transplantation: Results From a Randomized Study

Abstract

High-dose chemotherapy followed by autologous stem cell transplantation (ASCT) is frequently performed in patients with hematologic malignancies. ASCT can result in significant nausea, pain, and discomfort. Supportive care has improved, and pharmacologic therapies are frequently used, but with limitations. Music has been demonstrated to improve nausea and pain in patients undergoing chemotherapy, but little data are available regarding the effects of music therapy in the transplantation setting. In a prospective study, patients with lymphoma or multiple myeloma undergoing ASCT were randomized to receive either interactive music therapy with a board-certified music therapist or no music therapy. The music therapy arm received 2 music therapy sessions on days +1 and +5. Primary outcomes were perception of pain and nausea measured on a visual analog scale. Secondary outcomes were narcotic pain medication use from day -1 to day +5 and impact of ASCT on patient mood as assessed by Profile of Mood States (POMS) on day +5. Eighty-two patients were enrolled, with 37 in the music therapy arm and 45 in the no music therapy arm. Patients who received MT had slightly increased nausea by day +7 compared with the no music therapy patients. The music therapy and no music therapy patients had similar pain scores; however, the patients who received music therapy used significantly less narcotic pain medication (median, 24 mg versus 73 mg; P = .038). Music therapy may be a viable nonpharmacologic method of pain management for patients undergoing ASCT; the music therapy patients required significantly fewer morphine equivalent doses compared with the no music therapy patients. Additional research is needed to better understand the effects of music therapy on patient-perceived symptoms, such as pain and nausea.

Music Therapy in the Psychosocial Treatment of Adult Cancer Patients: A Systematic Review and Meta-Analysis

“…In one study with two song-based music therapy sessions per week, greater improvements in mood, but no differences in self-rated pain were observed in comparison with the control group (Dóro et al, 2017). In another trial using non-standardized interventions, patients receiving two music therapy sessions required less pain medication even though the subjective pain reduction was similar in music therapy and the control group (Bates et al, 2017). The reduction in analgesics intake was also found in a similar study, where stem cell transplantation patients additionally reported a short-term reduction of subjective pain perception (Tuinmann et al, 2017).…”

Nutritional problems and their non‐pharmacological treatment in adults undergoing haematopoietic stem cell transplantation—A systematic review

“…The programme had a positive short‐term effect on diarrhoea ( p = 0.014) but no effect at all on nausea (Jarden, Baadsgaard, Hovgaard, Boesen, & Adamsen, 2009). One study investigated the impact of music therapy on nausea and found a significant difference with regard to the nausea score in favour of the control group after 7 days ( p = 0.035), but no differences were observed at other time points (after 1 and 5 days) (Bates et al., 2017).…”

Influence of music therapy on the telomere length: a brief review and a pilot study

“…Music therapy significantly reduced anxiety and helped to improve both the mood and subjective assessment of life quality of cancer patients preparing for radiotherapy treatment or undergoing it (Rossetti et al, 2017). It can also be a reasonable non-pharmacological method of coping with pain in the case of patients undergoing bone marrow transplantation: patients whose treatment included music therapy proved to need significantly lower doses of pain medication (Bates et al, 2017). These data are in agreement with recent results that showed a significant improvement in treatment, and increased survival, accompanied by reduction in cortisol and the telomere length, in patients with tumours, who actively participated in a long-term program of supportive psychotherapy adjusted for individual patterns (Carlson et al, 2015;.…”