Randomized trial of inpatient palliative care in patients hospitalized for hematopoietic stem cell transplantation (HCT).

103 Background: During HCT, patients experience physical and psychological symptoms that negatively impact their quality of life (QOL). We assessed the impact of an inpatient palliative care intervention on patient QOL, symptom burden, and mood during HCT hospitalization and at 3 months post-HCT.

METHODS: We randomized 160 patients with hematologic malignancies admitted for autologous or allogeneic HCT to an inpatient palliative care intervention (n=81) integrated with transplant care compared to transplant care alone (n=79). We used the Functional Assessment of Cancer Therapy-Bone Marrow Transplant (FACT-BMT) to assess QOL, the Hospital Anxiety and Depression Scale (HADS) and Patient Health Questionnaire (PHQ-9) to assess mood, and Edmonton Symptom Assessment Scale (ESAS) to measure symptoms at baseline, week-2, and 3 months post-HCT. We measured post-traumatic stress (PTSD) symptoms using the PTSD checklist at baseline and 3 months post-HCT. We used linear regression models controlling for baseline values to assess the intervention effects on outcomes at week-2 and 3 months post-HCT.

RESULTS: Between 8/2014 and 1/2016, we enrolled 160/186 (86%) of potentially eligible patients. At week-2, the intervention led to improvements in QOL, depression, anxiety, and symptom burden. At 3 months post-HCT, the intervention led to improvements in QOL, depression, and PTSD [Table 1]. PHQ-9 scores at week-2 and HADS-anxiety scores at 3 months did not differ significantly.

CONCLUSIONS: Palliative care improved QOL, depression, anxiety, and symptom burden in patients hospitalized for HCT with notable sustained effects 3 months post-HCT. Involvement of palliative care for patients with hematologic malignancies can improve their outcomes and substantially reduce the morbidity of HCT.

CLINICAL TRIAL INFORMATION: NCT02207322. [Table: see text].