Mental status changes after hematopoietic stem cell transplantation Exercise during hematopoietic stem cell transplant hospitalization in children. Use of Chamomilla recutita in the Prevention and Treatment of Oral Mucositis in Patients Undergoing Hematopoietic Stem Cell Transplantation: A Randomized, Controlled, Phase II Clinical Trial Facing the Challenges of Hematopoietic Stem Cell Transplantation With Mindfulness Meditation: A Pilot Study Fatigue and physical activity in patients undergoing hematopoietic stem cell transplant. Physical activity for patients undergoing an allogeneic hematopoietic stem cell transplantation: benefits of a moderate exercise intervention. Safety, Pharmacokinetics, and Efficacy of Palifermin in Children and Adolescents with Acute Leukemias Undergoing Myeloablative Therapy and Allogeneic Hematopoietic Stem Cell Transplantation: A Pediatric Blood and Marrow Transplant Consortium Trial.
The growing numbers of survivors of innovative cancer treatments  , such as hematopoietic stem cell transplantation ( HSCT )  , often report subsequent cognitive difficulties . The objective of this study was to evaluate and compare neurocognitive changes in patients with chronic myelogenous leukemia ( CML ) or primary myelodysplastic syndrome ( MDS ) after allogeneic HSCT or other therapies PURPOSE The purpose of this controlled trial was to assess the effect of an approximately 3-wk intrahospital exercise intervention performed during inpatient hospitalization for pediatric allogeneic hematopoietic stem cell transplant ( HSCT ) on ( i ) immune cell recovery and ( ii ) body composition . METHODS Immune ( i.e. , blood counts of leukocytes , monocytes , lymphocytes , and lymphocyte sub population s ) and anthropometric variables ( i.e. , body mass , body mass index , and estimated fat-free mass ) were measured before and after ( + 15 and 30 d ) HSCT . Seven children ( 5 boys and 2 girls ; age ( mean + /- SD ) = 8 + /- 4 yr ) with high-risk cancer performed an individualized training program ( aerobic + resistance exercises ) in their isolated hospital rooms . We also assessed a control group ( n = 13 ; 9 boys and 4 girls ; age = 7 + /- 3 yr ) with similar medical conditions and following the same transplant protocol . RESULTS In both groups , the dendritic cell count decreased from pre-HSCT to + 15 d post-HSCT and thereafter ( up to + 30 d ) remained stabile ; however , the posttransplant decrease was more abrupt in the control group than that in the intervention group ( -87 % vs -63 % , respectively , from pre-HSCT to + 15 d ) . The rest of the immune cell parameters measured showed a similar response from pre-HSCT to post-HSCT in both groups . We found a significant effect of the interaction group x time for all anthropometric variables ( weight , body mass index , body fat , and fat-free mass ) , indicating an increase over the hospitalization period only in the intervention group , for example , body mass increased from 32.9 + /- 18.7 kg pre-HSCT to 35.4 + /- 18.6 kg at + 30 d in the intervention group versus a decrease from 30.2 + /- 16.6 to 29.3 + /- 6.3 kg in the control group . CONCLUSION Our findings support the feasibility of exercise training interventions during hospitalization , including immunocompromised children Background : Oral mucositis is a common inflammatory complication among patients undergoing hematopoietic stem cell transplantation ( HSCT ) . Among its therapeutic properties , Chamomilla recutita has anti-inflammatory effects . Objective : The aim of this study was to identify the dosage of the liquid extract of C recutita in mouthwash that is needed to reduce the incidence and intensity of oral mucositis in adult patients undergoing allogenic HSCT . Methods : In a r and omized phase II clinical trial , 40 patients were r and omized to receive routine care plus mouthwash containing a liquid extract of C recutita at 0.5 % , 1 % , or 2 % ( experimental groups ) or st and ard care alone ( control group ) . Daily evaluation was performed using the measurement scale for oral toxicity defined by the World Health Organization . Statistical analysis was performed , in which the incidence , intensity , and duration of oral mucositis were compared between each experimental group and the control group . Results : The experimental group at the 1 % dosage demonstrated reduced incidence , intensity , and duration of oral mucositis compared with the control group . The formulation was well tolerated by patients and was safe , as no moderate or severe adverse effects were identified . Conclusions : In this study , the use of mouthwash containing 1 % C recutita extract can be associated with reduced incidence , intensity , and duration of mucositis in adults patients undergoing allogenic HSCT . Implication s for Practice : The results of this investigation will help nurses and other professionals in selecting the C recutita dosage used to manage oral mucositis in patients undergoing HSCT The hematopoietic stem cell transplant ( HSCT ) experience is emotionally and physically stressful for cancer patients who undergo this procedure .  Mindfulness-based interventions have been studied in patients with various diagnoses , including cancer , although minimal work has applied this intervention to hospitalized patients . Use of mindfulness meditation has potential to provide HSCT patients with coping skills to deal with unpleasant symptoms and an uncertain future . This exploratory study examined feasibility , physiological arousal , and psychological and physical symptoms in HSCT patients participating in a mindfulness meditation intervention that begins before and continues throughout hospitalization and involves one-on-one guided sessions and daily practice using a 17-minute meditation CD .  Of the 20 participants , 78.9 % completed the intervention . Statistically significant decreases in heart and respiratory rates and improvements in symptoms immediately before and after each session were found . These findings demonstrate feasibility and preliminary support of a mindfulness meditation intervention with symptomatic , hospitalized cancer patients PURPOSE / OBJECTIVES To examine the patterns of fatigue , physical activity , health status , and quality of life before and after  high-dose chemotherapy and hematopoietic stem cell transplantation ( HSCT )  and to examine the feasibility of obtaining real-time fatigue and physical activity data . DESIGN Prospect i ve , repeated measures . SETTING Two midwestern academic medical centers . SAMPLE Convenience sample of autologous or allogeneic patients undergoing HSCT ( N = 20 baseline , N = 17 post-transplant ) . METHODS Subjects were assessed over a five-day period before and after HSCT for a total of 10 days . Subjects rated fatigue intensity three times daily and wore a wrist actigraph to measure physical activity .  At the end of both five-day periods , subjects completed measures of perceived health status ( European Organization for Research and Treatment of Cancer Quality of Life Question naire-Core 30 ) and life satisfaction Quality of Life Index ) . MAIN RESEARCH VARIABLES Fatigue , physical activity , perceived health status , and quality of life . FINDINGS Study results indicate that fatigue significantly increased and physical activity decreased following high-dose chemotherapy and HSCT . The decline coincided with diminished physical , emotional , role , and cognitive functioning . The symptoms that patients experienced ( i.e. , fatigue , pain , nausea and vomiting , sleep disturbances , appetite loss , and diarrhea ) increased during the acute post-transplant period . No significant changes in life satisfaction were found . CONCLUSIONS The study findings suggest that patients receiving high-dose chemotherapy followed by HSCT  experience increased fatigue , reduced physical activity , diminished functioning , and poorer quality of life immediately after transplant . Findings demonstrate that real-time fatigue and physical activity data can feasibly be collected in acutely ill patients . IMPLICATION S FOR NURSING Patients undergoing HSCT require considerable supportive nursing care immediately following transplant . Clinicians and research ers need to strive for effective symptom management to improve the likelihood of successful outcomes UNLABELLED An allogeneic hematopoietic stem cell transplantation ( HSCT ) can have profound and lasting adverse effects on a patient 's physical and psychological well-being . So far , only few studies have investigated the effectiveness of physical activity over the entire inpatient phase of an allogeneic HSCT . PURPOSE We performed a r and omized controlled study to examine the influence of a controlled moderate exercise program starting parallel to chemotherapeutic conditioning and total body irradiation on the patient 's physical and psychological constitution . PATIENTS AND METHODS Forty-seven patients undergoing an allogeneic HSCT were r and omly assigned to an exercise group ( EG ) or a control group ( CG ) . While the EG took part in an endurance and activity of daily living-training twice a day , the CG received the clinic 's st and ard physiotherapy program once a day . RESULTS Significant differences and /or trends in favor of the EG were observed regarding the primary endpoint endurance performance ( P=0.002 ) , muscular strength ( P=0.022 ) , fatigue ( P=0.046 ) , and emotional state ( P=0.028 ) without posing an additional risk for the individual . CONCLUSION The results show that the training program is feasible and seems to have positive influences on physical performance and quality of life in patients undergoing an allogeneic HSCT . However , further studies are necessary to confirm these results Currently , effective pharmacologic treatment to reduce severe oral mucositis ( OM ) result ing from high-dose myeloablative cytotoxic therapy in the pediatric population is not available . Palifermin has been proven to decrease the incidence and duration of severe OM in adults with hematologic malignancies undergoing hematopoietic stem cell transplantation ( HSCT ) . In the pediatric population , however , data on palifermin treatment are limited . A phase I dose-escalation study of palifermin in pediatric patients with acute leukemias undergoing myeloablative HSCT with total body irradiation , etoposide , and cyclophosphamide  was performed to determine a safe and tolerable dose and to characterize the pharmacokinetic ( PK ) profile and efficacy of palifermin . Twenty-seven patients in 3 age groups ( 1 to 2 , 3 to 11 , and 12 to 16 years ) and 3 dose levels ( 40 , 60 , and 80 μg/kg/day ) were studied . There were no deaths , dose-limiting toxicities , or treatment-related serious adverse events . Long-term safety outcomes did not differ from what would be expected in this population . PK data showed no differences between the 3 age groups . Exposure did not increase with increase in dose . The maximum severity of OM ( WHO grade 4 ) occurred in 6 patients ( 22 % ) , none of whom was in the 80-μg/kg/day dosing group . This study showed that all doses were well tolerated and a good safety profile in all 3 pediatric age groups was seen
Only three multi-item and two single-item instruments were identified as being reliable and valid among pediatric cancer or HSCT patients and would therefore be appropriate to measure anxiety in this population
Purpose The primary objective was to describe anxiety measurement instruments used in children and adolescents with cancer or undergoing hematopoietic stem cell transplantation ( HSCT )  and summarize their content and psychometric properties .