Racioppi Alessandro, Dalton Tara, Ramalingam Sendhilnathan, Romero Kristi, Ren Yi, Bohannon Lauren, Arellano Consuelo, Jonassaint Jude, Miller Hilary, Barak Ian, Fish Laura J, Choi Taewoong, Gasparetto Cristina, Long Gwynn D, Lopez Richard D, Rizzieri David A, Sarantopoulos Stefanie, Horwitz Mitchell E, Chao Nelson J, Shah Nirmish R, Sung Anthony D
Duke University School of Medicine, Durham, North Carolina; Division of Hematologic Malignancies and Cellular Therapy, Department of Medicine, Duke University Medical Center, Durham, North Carolina.
Duke University School of Medicine, Durham, North Carolina.
Transplant Cell Ther. 2021 Feb;27(2):181.e1-181.e9. doi: 10.1016/j.jtct.2020.10.017. Epub 2020 Dec 13.
Hematopoietic stem cell transplantation (HCT) is a curative treatment option for patients with hematologic conditions but presents many complications that must be managed as a complex, chronic condition. Mobile health applications (mHealth apps) may permit tracking of symptoms in HCT. In seeking strategies to manage the complexities of HCT, our team collaborated with Sicklesoft, Inc., to develop an mHealth app specifically for HCT patients to allow for daily evaluation of patient health, Technology Recordings to better Understand Bone Marrow Transplantation (TRU-BMT). The primary value of this application is that of potentially enhancing the monitoring of symptoms and general health of patients undergoing HCT, with the ultimate goal of allowing earlier detection of adverse events, earlier intervention, and improving outcomes. To first evaluate patient interest in mHealth apps, we designed and administered an interest survey to patients at the 2017 BMT-InfoNet reunion. As a follow-up to the positive feedback received, we began testing the TRU-BMT app in a Phase 1 pilot study. Thirty patients were enrolled in this single-arm study and were given the TRU-BMT mHealth app on a smartphone device in addition to a wearable activity tracker. Patients were followed for up to 180 days, all the while receiving daily app monitoring. Adherence to TRU-BMT was approximately 30% daily and 44% weekly, and greater adherence was associated with increased meal completion, decreased heart rate, and shorter hospital stay. TRU-BMT assessments of symptom severity were significantly associated with duration of hospital stay and development of chronic graft-versus-host disease. Our findings suggest that using TRU-BMT throughout HCT is feasible for patients and established a proof-of-concept for a future randomized control trial of the TRU-BMT application in HCT. © 2021 American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.
造血干细胞移植（HCT）是血液系统疾病患者的一种治愈性治疗选择，但会出现许多并发症，必须作为一种复杂的慢性病来管理。移动健康应用程序（mHealth应用）可能有助于追踪造血干细胞移植患者的症状。为了寻求管理造血干细胞移植复杂性的策略，我们的团队与Sicklesoft公司合作，开发了一款专门针对造血干细胞移植患者的移动健康应用程序，以便对患者健康进行每日评估，即技术记录以更好地了解骨髓移植（TRU-BMT）。该应用程序的主要价值在于有可能加强对接受造血干细胞移植患者症状和总体健康状况的监测，最终目标是更早地发现不良事件、更早地进行干预并改善治疗结果。为了首先评估患者对移动健康应用程序的兴趣，我们在2017年BMT-InfoNet聚会上设计并向患者发放了一份兴趣调查问卷。作为对收到的积极反馈的后续行动，我们开始在一项1期试点研究中测试TRU-BMT应用程序。30名患者参与了这项单臂研究，除了佩戴一个可穿戴活动追踪器外，还在智能手机设备上安装了TRU-BMT移动健康应用程序。对患者进行了长达180天的随访，在此期间一直接受应用程序的每日监测。TRU-BMT的每日使用率约为30%，每周使用率为44%，更高的使用率与进餐完成率提高、心率降低和住院时间缩短相关。TRU-BMT对症状严重程度的评估与住院时间和慢性移植物抗宿主病的发生显著相关。我们的研究结果表明，在整个造血干细胞移植过程中使用TRU-BMT对患者来说是可行的，并为TRU-BMT应用于造血干细胞移植的未来随机对照试验建立了概念验证。©2021美国血液和骨髓移植学会。由爱思唯尔公司出版。保留所有权利。
