Inpatient Palliative Care for Patients Undergoing Hematopoietic Stem Cell Transplantation

NCT ID: NCT03641378

Last Updated: 2023-12-07

Study Results

Results available

Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

546 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-09-30

Study Completion Date

2023-07-01

Brief Summary

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This research study is evaluating the impact of early involvement of a palliative care team working with the transplant oncology team will have on the quality of life, symptoms, and mood of patients undergoing stem cell transplantation.

Detailed Description

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The Participant has a type of blood cancer and will be undergoing stem cell transplantation. Frequently people undergoing stem cell transplantation experience physical and emotional symptoms during the course of their hospitalization for stem cell transplantation. These can be very distressing to both patient and the family members. The study doctors want to know if the early introduction of a team of clinicians that specialize in the lessening (palliation) of many of these distressing symptoms may improve the participant overall care.

This team of clinicians is called the palliative care team and they focus on ways to improve the participant pain and other symptom management (nausea, fatigue, shortness of breath, anxiety, etc.) and to assist the participant and the participant's family in coping with the emotional and social issues associated with your diagnosis. The team consists of physicians and advance practice nurses who have been specially trained in the care of patients facing serious illness.

The main purpose of this study is to compare two types of care - standard transplant oncology care and standard transplant oncology care with early involvement of palliative care clinicians to see which is better for improving the experience of patients and families with blood cancers undergoing stem cell transplantation.

The purpose of this research study is to find out whether introducing patients and families undergoing stem cell transplantation to the palliative care team that specializes in symptom management can improve the physical and psychological symptoms that patients and families experience during hospitalization for stem cell transplantation.

The study will use a series of questionnaires to measure the participant and the participant 's caregivers' quality of life, physical symptoms, and mood. Study questionnaires will be completed in the hospital or clinic with assistance provided as need.

Conditions

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Stem Cell Transplant

Keywords

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Cancer Care

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Inpatient Palliative Care Intervention

* Patients and Caregivers will complete baseline self-report assessments at the time of obtaining informed consent
* Palliative Care Intervention
* Therapeutic Relationship

--Develop a strong therapeutic relationship with patients and caregivers
* Assessment and Treatment of Patient Symptoms

--Clarify the symptoms the patient will likely experience and offer reassurance about the methods for reporting and treating symptoms
* Managing Patients and Caregivers Expectations

--Address early on patients and caregivers' concerns about the trajectory of illness during HCT and treatment side effects
* Coping with Illness and HCT --Introduce strategies to help improve adjustment (e.g., behavioral, cognitive, and spiritual approaches; accepting illness while maintaining hope; social support)

Group Type EXPERIMENTAL

Palliative Care Intervention

Intervention Type OTHER

team of clinicians that specialize in the lessening (palliation) of many distressing symptoms

Transplant Care Alone

* Patients and Caregivers will complete baseline self-report assessments at the time of obtaining informed consent.
* Standard Transplant Care

Group Type EXPERIMENTAL

Standard Transplant Care

Intervention Type OTHER

Standard care per hospital guidelines

Interventions

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Palliative Care Intervention

team of clinicians that specialize in the lessening (palliation) of many distressing symptoms

Intervention Type OTHER

Standard Transplant Care

Standard care per hospital guidelines

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* adult patients (≥ 18 years) with hematologic malignancy admitted for autologous or allogeneic HCT.
* ability to read and respond to questions in English or Spanish or to complete questionnaires with assistance from an interpreter.

Caregiver Eligibility Criteria:

* adult (≥ 18 years) relative or a friend of a patient who agrees to participate in the study whom the patient identified as living with them or having in-person contact with him or her at least twice per week.
* ability to read and respond to questions in English or Spanish or to complete questionnaires with the assistance of an interpreter.

Exclusion Criteria

* Patients undergoing HCT for benign hematologic conditions
* Patients undergoing outpatient HCT.
* Patients with psychiatric or cognitive conditions which the treating clinicians believes prohibits compliance with study procedures
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Institutes of Health (NIH)

NIH

Sponsor Role collaborator

National Cancer Institute (NCI)

NIH

Sponsor Role collaborator

Massachusetts General Hospital

OTHER

Sponsor Role lead

Responsible Party

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El-Jawahri, Areej,M.D.

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Areej El-Jawahri, MD

Role: PRINCIPAL_INVESTIGATOR

Massachusetts General Hospital

Locations

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Massachusetts General Hospital

Boston, Massachusetts, United States

Site Status

Duke University

Durham, North Carolina, United States

Site Status

Fred Hutchinson Cancer Research Center

Seattle, Washington, United States

Site Status

Countries

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United States

References

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El-Jawahri A, LeBlanc TW, Kavanaugh A, Webb J, Fausto J, Traeger L, Greer JA, Jackson V, Horick N, Rabideau DJ, Fenech A, Newcomb R, Ufere NN, Caruso E, Pepper J, DeFilipp Z, Chen YB, Lee SJ, Temel JS. Multisite Randomized Trial of Inpatient Palliative Care Intervention for Patients Undergoing Hematopoietic Stem Cell Transplantation. J Clin Oncol. 2025 Aug 20;43(24):2700-2711. doi: 10.1200/JCO-25-00378. Epub 2025 Jun 23.

Reference Type DERIVED
PMID: 40549982 (View on PubMed)

Newcomb R, Amonoo HL, Kavanaugh AR, Wharton KC, Rowland M, Fausto J, Webb J, Jackson V, Greer JA, Temel JS, Lark P, Rabideau DJ, O'Brien K, LeBlanc TW, Lee SJ, El-Jawahri A. Factors associated with early quality-of-life response to palliative care during hematopoietic cell transplantation. Blood Adv. 2025 May 13;9(9):2033-2043. doi: 10.1182/bloodadvances.2024014574.

Reference Type DERIVED
PMID: 39908568 (View on PubMed)

Yang D, Newcomb R, Kavanaugh AR, Khalil D, Greer JA, Chen YB, DeFilipp Z, Temel J, Lee SJ, LeBlanc TW, El-Jawahri A. Protocol for multi-site randomized trial of inpatient palliative care for patients with hematologic malignancies undergoing hematopoietic stem cell transplantation. Contemp Clin Trials. 2024 Mar;138:107460. doi: 10.1016/j.cct.2024.107460. Epub 2024 Jan 26.

Reference Type DERIVED
PMID: 38280483 (View on PubMed)

Newcomb R, Amonoo HL, Nelson AM, Choe J, Holmbeck K, Nabily A, Lee SJ, LeBlanc TW, El-Jawahri A. Coping in patients with hematologic malignancies undergoing hematopoietic cell transplantation. Blood Adv. 2024 Mar 26;8(6):1369-1378. doi: 10.1182/bloodadvances.2023011081.

Reference Type DERIVED
PMID: 38181820 (View on PubMed)

Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Other Identifiers

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R01CA222014

Identifier Type: NIH

Identifier Source: secondary_id

View Link

18-261

Identifier Type: -

Identifier Source: org_study_id