Institute of Medical Science, University of Toronto, Toronto, ON, Canada.
Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.
Blood Adv. 2024 Sep 24;8(18):4778-4791. doi: 10.1182/bloodadvances.2024012968.
Allogeneic blood and marrow transplantation (alloBMT) is a curative treatment for blood cancers associated with various treatment-related adverse events and morbidities for which rehabilitation programs are currently limited. A phase 2 randomized controlled trial (RCT) was conducted to assess the feasibility, acceptability, and impact of CaRE-4-alloBMT, a longitudinal, multidimensional cancer rehabilitation program for patients undergoing alloBMT. The primary outcomes included the feasibility and acceptability of the intervention and the methods. Feasibility was assessed through recruitment, retention, and adherence rates. Acceptability was assessed through qualitative interviews. Secondary clinical outcomes were collected through questionnaires and physiological assessments at 4 time points. A total of 80 participants were recruited and randomized. Recruitment (72%) and retention (70%) rates, along with qualitative findings, support the feasibility of the intervention. Adherence was suboptimal, most notably educational module completion (22.7%). Treatment effect sizes of 0.70 (95% confidence interval [CI], 0.20-1.21; 30-second sit-to-stand test) and 0.46 (95% CI, -0.17 to 1.09; 36-Item Short Form Survey) were observed in favor of the intervention. The results appear promising; however, the findings are limited by missing data owing to attrition. Modifications will be required to refine the program and inform a phase 3 RCT. This trial was registered at www.ClinicalTrials.gov as #NCT04966156.
异基因造血干细胞移植(alloBMT)是治疗与各种治疗相关不良事件和发病率相关的血液癌的一种有治愈可能的方法,但目前康复方案有限。一项 2 期随机对照试验(RCT)旨在评估 CaRE-4-alloBMT 的可行性、可接受性和影响,这是一个针对 alloBMT 患者的纵向、多维癌症康复方案。主要结果包括干预措施和方法的可行性和可接受性。可行性通过招募、保留和依从性来评估。可接受性通过定性访谈来评估。次要临床结果通过问卷调查和 4 个时间点的生理评估收集。共招募并随机分配了 80 名参与者。招募(72%)和保留(70%)率以及定性研究结果均支持该干预措施的可行性。然而,参与度并不理想,尤其是教育模块的完成率(22.7%)。干预的治疗效果大小为 0.70(95%置信区间[CI],0.20-1.21;30 秒坐站测试)和 0.46(95%CI,-0.17 至 1.09;36 项简短健康调查),均有利于干预措施。尽管由于参与者流失导致数据缺失,但结果仍然有希望。需要进行修改以完善该方案,并为 3 期 RCT 提供信息。该试验在 www.ClinicalTrials.gov 上注册,编号为 #NCT04966156。