BMC Palliative Care (Jul 2024)

Impact of early palliative care intervention in autologous bone marrow transplantation: feasibility of a multicentric study

  • María Argüello-Marina,
  • Marta Callejas-Charavía,
  • Beatriz Merchán-Muñoz,
  • Daniel Gainza-Miranda,
  • Agustina Rico-Zampetti,
  • Raquel Pérez-Maganto,
  • Gustavo Ruiz-Ares,
  • Patricia García-Ramírez,
  • Dunia de Miguel-Llorente,
  • Julio García-Suárez

DOI
https://doi.org/10.1186/s12904-024-01499-z
Journal volume & issue
Vol. 23, no. 1
pp. 1 – 8

Abstract

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Abstract Introduction This prospective multicentre study evaluates the impact of Palliative Care Unit (PCU) intervention (Experimental Group, EG), during autologous hematopoietic stem cell transplantation (AHSCT) on quality of life (QoL), symptom control and healthcare resource use compared to standard practice (Control Group, CG). We used validated scales on Days 0 (stem cell infusion), + 7 (bone marrow aplasia, acute symptoms) and + 21 (aplasia recovery). Results In 40 patients (20 EG/ 20 CG: 45%/25% female, median age 57.5/59), QoL differed significantly at Day + 7 (EG: median 0.50; CG: -63.00; p < 0.001) and Day + 21 (EG: -2.00; CG: -129.00; p < 0.001). On Day 0, mean FACT-BMT scores were CG/EG: 131/ 89.35, reflecting the pre-transplant intervention of the PCU in EG patients. For pain (EG median 0.00, CG median 2.50; p = 0.01), 45% EG patients used opioids on day 0 (mean 38.5 mg morphine/day/patient). Reduced pain control impacted nutritional support (parenteral nutrition 45% CG, 5% EG; p = 0.08). Hospitalisation duration was longer in CG (median 18.5; EG median 13.00; p < 0.001). Despite the short follow-up and small sample size, PCU and HD collaboration improves QoL and symptom management during acute AHSCT, evident through pain control, analgesia management, reduced parenteral nutrition need and shorter hospital stays.

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