Pilot study explores new approach for reducing anxiety and improving quality of life after stem cell transplantation

New research in the June 2024 issue of Journal of the National Comprehensive Cancer Network highlights a promising approach for alleviating distress, enhancing quality of life, improving physical function, and reducing fatigue in patients with blood cancers who undergo hematopoietic stem cell transplantation (HSCT).

The study, “A Positive Psychology Intervention in Allogeneic Hematopoietic Stem Cell Transplantation Survivors (PATH): A Pilot Randomized Clinical Trial,” used a randomized clinical trial to evaluate the feasibility of a nine-week, phone-delivered, positive psychology program called Positive Affect for the Transplantation of Hematopoietic stem cells intervention (PATH), that was specifically tailored to the needs of this population.

The findings indicate that the PATH intervention is both feasible and well-received by this patient population, as most of the patients (91%) who received the PATH intervention completed all of the intervention sessions and found them easy and helpful.

“Having nine out of 10 people complete all the sessions is great,” explained lead researcher Hermioni L. Amonoo, MD, MPP, MPH, Brigham and Women’s Hospital/Dana-Farber Cancer Institute.

“We designed PATH with the needs of HSCT survivors in mind. First, PATH is accessible to patients, as they can learn the skills and engage with the intervention over phone from wherever they are—eliminating the need to travel to the cancer center. Second, the weekly exercises can be completed by patients at their convenience using the PATH manual, which guides patients on how to use the exercises and skills.

“This means that the actual phone sessions only last 15–20 minutes, in contrast to other well-established psychotherapies like cognitive behavioral therapy, which typically last 60–90 minutes per session.

“Third, we carefully curated the intervention sessions based on which activities patients can safely engage in while their immune system recovers following the transplant. For instance, unlike in other medical populations, we did not include exercises that focus on community service, which might unnecessarily expose patients to risks.”

The pilot study was conducted at the Brigham and Women’s Hospital/Dana-Farber Cancer Institute from August 2021 to August 2022. A total of 70 adult patients with blood cancers who have received HSCT, were randomized into two groups, with the intervention beginning about 100 days after HSCT.

Those randomized into the PATH arm participated in a variety of weekly positive psychology exercises focused on gratitude, personal strengths, and meaning. Not only was participation high—94% completed at least six of the nine sessions and 91% completed all nine—the intervention had promising effects on patient-reported outcomes immediately after completion of the program and again at week 18.

Dr. Amonoo added, “Cancer care providers should consider the potential benefits of psychosocial resources and interventions like PATH that focus on enriching positive emotions to bolster their patients’ well-being.

“While the active identification and treatment of psychological distress, like anxiety, in patients with cancer are crucial, encouraging patients to engage in simple, structured, and systematic exercises aimed at fostering positive thoughts and emotions, such as gratitude, has the potential to enhance well-being as well.”

“This positive psychology intervention highlights the importance of not only screening for distress but the promise of creating mechanisms that enhance well-being and reduce distress in our patients,” commented Jessica Vanderlan, Ph.D., Manager, Siteman Psychology Service, Licensed Clinical Psychologist, Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine, Vice Chair of the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) Panel for Distress Management—who was not involved in this research.

“Development of clinical interventions that are brief (15–20 minutes) and delivered by phone could greatly improve patient access to care. This type of accessibility is important in an oncology population, especially in acute recovery periods with many competing demands and physical symptoms.”

Provided by
National Comprehensive Cancer Network