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Exercise and Stress Management Post Autologous and Allogeneic Transplant (BMT CTN 0902)

Not Applicable
Completed
Conditions
Physiological Stress
Registration Number
NCT01278927
Lead Sponsor
Medical College of Wisconsin
Brief Summary

This is a Phase III, randomized, unblinded, multicenter, prospective comparative study. The purpose of this study is to test whether exercise or stress management training delivered to autologous and allogeneic hematopoietic cell transplantation (HCT) patients prior to transplantation can improve functional status and the transplant experience.

Detailed Description

Background:

The adverse effects of hematopoietic cell transplantation (HCT) on short and long term quality of life are well documented. Patients experience numerous aversive symptoms (e.g., nausea, fatigue, and sleep disturbance) that are accompanied by declines in physical and mental well-being. Although most longitudinal studies show return to baseline functioning for the majority of patients, it may take 6 to 12 months or longer to reach this goal. Clinical trials have shown that training in stress management techniques and participation in formal exercise programs each offered in isolation are effective in improving quality of life in patients receiving standard-dose chemotherapy and HCT. Review of these studies suggests that stress management interventions primarily improve mental health outcomes and nausea. The impact of exercise training interventions is more variable; most studies report physical health benefits, with some studies also reporting mental health benefits. Small studies suggest that combining stress management training and exercise are feasible and well-tolerated, but whether the combination provides an additive or synergistic impact on quality of life outcomes has not been directly investigated.

Design Narrative:

The protocol is designed as a factorial trial with two interventions, exercise and stress management, which results in four treatment arms: standard care, exercise only, stress management only and the combination of exercise and stress management. The primary objective of this randomized phase III trial is to test the ability of exercise training or stress management training to improve physical and mental functioning at Day 100 post hematopoietic cell transplantation.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
711
Inclusion Criteria
  • Age 18 years or older
  • Able to speak and read English
  • Able to exercise at low to moderate intensity - adequate cardiopulmonary reserve, as judged by self-reported ability to walk up one flight of stairs, no requirement for supplemental oxygen, and physician judgment
  • Willing and able to provide informed consent.
  • Stated willingness to comply with study procedures and reporting requirements
  • Planned autologous or allogeneic transplantation within 6 weeks.
Exclusion Criteria
  • Orthopedic, neurologic or other problems which prevent safe ambulation and protocol adherence
  • Participation in another clinical trial with quality of life or functional status as a primary endpoint

Study & Design

Study Type
INTERVENTIONAL
Study Design
FACTORIAL
Primary Outcome Measures
NameTimeMethod
Functional Status100 days

To determine whether exercise or stress management improves self-reported physical and mental functioning compared to standard care at 100 days post hematopoietic cell transplantation (HCT) using evaluated patients. The Physical Component Score (PCS) and Mental Component Score (MCS) of the SF-36 will be the primary endpoint measures of functional status. Raw scores are converted to a standard metric (0-100), with higher scores being indicative of a better health state.

Secondary Outcome Measures
NameTimeMethod
SF-36 Late Outcomes6 months

The SF-36 PCS and MCS will be collected from participants at six months. Raw scores are converted to a standard metric (0-100), with higher scores being indicative of a better health state.

Cancer and Treatment Distress (CTXD)100 days

Cancer and treatment distress will be measured by the acute version of the Cancer and Treatment Distress (CTXD) scale, a 27 item validated measure of distress with domains of Uncertainty, Health Burden, Family Strain, Identity and Managing the Medical System used extensively in HCT studies. The scale ranges from 0 - 3, where a higher score reflects more distress.

The Pittsburgh Sleep Quality Index (PSQI)100 days

The Pittsburgh Sleep Quality Index (PSQI) is a widely used seven item self-report measure of sleep patterns and difficulties. A modified version will be used to obtain self-reports of the following for the past week: sleep quality, sleep latency, sleep efficiency, and use of sleeping medications. The scale ranges from 0 - 21, where a higher score reflects worse sleep quality.

Survival6 months and 1 year

Both survival at 6 months and overall survival at last follow-up will be reported. Overall survival is defined as the interval between transplantation and death or last follow-up. Patients alive when the study closes or lost to follow up are censored at the date of last contact.

Symptoms100 days

Patients will complete the MOS 36-Item Short Form (SF-36), a widely used self-report measure designed to assess perceived health and functioning, contains eight scales: Physical Functioning (PF), Role-Physical (R-P); Bodily Pain (BP); General Health (GH); Vitality (VT); Social Functioning (SF); Mental Health (MH); and Role-Emotional (R-E). Scales are comprised of different numbers of items and use a variety of rating formats. Raw scores are converted to a standard metric (0-100), with higher scores being indicative of a better health state.

Nausea100 days

Two questions using a similar format as the SF-36 were added to measure nausea. The scale ranges from 1 - 5, where a higher score indicates worse nausea.

Days of Hospitalization100 days

The number of hospital days within the first 100 days after graft infusion will be collected for patients surviving at least 100 days.

Trial Locations

Locations (19)

City of Hope National Medical Center

🇺🇸

Duarte, California, United States

University of Florida College of Medicine

🇺🇸

Gainesville, Florida, United States

H. Lee Moffitt Cancer Center

🇺🇸

Tampa, Florida, United States

Emory University

🇺🇸

Atlanta, Georgia, United States

Blood & Marrow Transplant Program at Northside Hospital

🇺🇸

Atlanta, Georgia, United States

Rush University Medical Center

🇺🇸

Chicago, Illinois, United States

University of Michigan Medical Center

🇺🇸

Ann Arbor, Michigan, United States

Karmanos Cancer Institute

🇺🇸

Detroit, Michigan, United States

University of Minnesota

🇺🇸

Minneapolis, Minnesota, United States

Washington University, Barnes Jewish Hospital

🇺🇸

Saint Louis, Missouri, United States

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City of Hope National Medical Center
🇺🇸Duarte, California, United States

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