Acupuncture for reduction of symptom burden in multiple myeloma patients undergoing autologous hematopoietic stem cell transplantation: a randomized sham-controlled trial

Purpose Hematopoietic stem cell transplantation (HCT) is potentially curative for a number of hematologic malignancies, but is associated with high symptom burden. We conducted a randomized sham-controlled trial (RCT) to evaluate efficacy and safety of acupuncture as an integrative treatment for man...

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Vydáno v:Supportive care in cancer Ročník 26; číslo 2; s. 657 - 665
Hlavní autoři: Deng, Gary, Giralt, Sergio, Chung, David J., Landau, Heather, Siman, Jonathan, Search, Benjamin, Coleton, Marci, Vertosick, Emily, Shapiro, Nathan, Chien, Christine, Wang, Xin S., Cassileth, Barrie, Mao, Jun J.
Médium: Journal Article
Jazyk:angličtina
Vydáno: Berlin/Heidelberg Springer Berlin Heidelberg 01.02.2018
Springer
Springer Nature B.V
Témata:
Acupuncture
Acupuncture Therapy - methods
Analgesics
Blood cancer
Care and treatment
Chemotherapy
Clinical trials
Critical incidents
Dosage and administration
Drugs
Efficacy
Escalation
Evidence-based medicine
Female
Hematopoietic stem cell transplantation
Hematopoietic Stem Cell Transplantation - methods
Humans
Integrated care
Integrative medicine
Male
Medical treatment
Medicine
Medicine & Public Health
Multiple myeloma
Multiple Myeloma - therapy
Myeloma
Nausea
Nursing
Nursing Research
Oncology
Original Article
Pain
Pain management
Pain Medicine
Patients
Prospective Studies
Registration
Rehabilitation Medicine
Sleepiness
Stem cell transplantation
Stem cells
Symptom management
Transplantation, Autologous - methods
Transplants
Transplants & implants
Complementary therapies
Acupuncture
Symptom management
Hematopoietic stem cell transplantation
Integrative medicine
Multiple myeloma
ISSN:0941-4355, 1433-7339, 1433-7339
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Shrnutí:Purpose Hematopoietic stem cell transplantation (HCT) is potentially curative for a number of hematologic malignancies, but is associated with high symptom burden. We conducted a randomized sham-controlled trial (RCT) to evaluate efficacy and safety of acupuncture as an integrative treatment for managing common symptoms during HCT. Methods Adult patients with multiple myeloma undergoing high-dose melphalan followed by autologous HCT (AHCT) were randomized to receive either true or sham acupuncture once daily for 5 days starting the day after chemotherapy. Patients and clinical evaluators, but not acupuncturists, were blinded to group assignment. Symptom burden, the primary outcome was assessed with the MD Anderson Symptom Inventory (MDASI) at baseline, during transplantation, and at 15 and 30 days post transplantation. Results Among 60 participants, true acupuncture produced nonsignificant reductions in overall MDASI core symptom scores and symptom interference scores during transplantation ( P  = .4 and .3, respectively), at 15 days ( P  = .10 and .3), and at 30 days posttransplantation ( P  = .2 and .4) relative to sham. However, true acupuncture was significantly more efficacious in reducing nausea, lack of appetite, and drowsiness at 15 days ( P  = .042, .025, and .010, respectively). Patients receiving sham acupuncture were more likely to increase pain medication use posttransplantation (odds ratio 5.31, P  = .017). Conclusions Acupuncture was well tolerated with few attributable adverse events. True acupuncture may prevent escalation of symptoms including nausea, lack of appetite, and drowsiness experienced by patients undergoing AHCT, and reduce the use of pain medications. These findings need to be confirmed in a future definitive study. Trial registration NCT01811862
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ObjectType-Evidence Based Healthcare-1
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ISSN:0941-4355
1433-7339
1433-7339
DOI:10.1007/s00520-017-3881-7