TY - JOUR
T1 - Acupuncture for reduction of symptom burden in multiple myeloma patients undergoing autologous hematopoietic stem cell transplantation
T2 - a randomized sham-controlled trial
AU - Deng, Gary
AU - Giralt, Sergio
AU - Chung, David J.
AU - Landau, Heather
AU - Siman, Jonathan
AU - Search, Benjamin
AU - Coleton, Marci
AU - Vertosick, Emily
AU - Shapiro, Nathan
AU - Chien, Christine
AU - Wang, Xin S.
AU - Cassileth, Barrie
AU - Mao, Jun J.
N1 - Funding Information:
This study was approved by the Institutional Review Board (IRB) at Memorial Sloan Kettering Cancer Center. All procedures performed were in accordance with the ethical standards of the institutional research committee. Dr. Giralt has received honoraria from Celgene, Takeda, Amgen, Jazz, and Sanofi; served in a consulting/advisory role for Celgene, Takeda, Sanofi, Jazz, Amgen, and Janssen; received research funding from Celgene and Takeda. Dr. Landau has received honoraria from Takeda; served in a consulting/advisory role for Onyx, Spectrum, Takeda, and Prothena; received research funding from Onyx. The remaining authors declare no competing financial interests.
Funding Information:
Funding The study was funded by a grant from the Gateway for Cancer Research, and the MSK Integrative Medicine and Translational Research Grant. We also received support from the National Institutes of Health/ National Cancer Institute (NIH/NCI) Cancer Center Support Grant P30 CA008748, the AC Israel Foundation, and the Byrne Fund.
Funding Information:
Authors’ contributions We would like to thank Yi Chan, Matthew Weitzman, Theresa Affuso (acupuncturists); Khaula Malik, Kelsi Clement, Jeremy Taylor, Mollie McMahon, Janice DeRito (research study assistants); and Andrew Vickers, PhD (biostatistician) for their work in this study, which was supported by funding from the NIH/NCI Cancer Center Support Grant P30 CA008748. In addition, we thank IH and CS for their help in the preparation and submission of this manuscript, which was also supported by funding from NIH/NCI Cancer Center Support Grant P30 CA008748.
Publisher Copyright:
© 2017, Springer-Verlag GmbH Germany.
PY - 2018/2/1
Y1 - 2018/2/1
N2 - Purpose: Hematopoietic stem cell transplantation (HCT) is potentially curative for a number of hematologic malignancies, but is associated with high symptom burden. We conducted a randomized sham-controlled trial (RCT) to evaluate efficacy and safety of acupuncture as an integrative treatment for managing common symptoms during HCT. Methods: Adult patients with multiple myeloma undergoing high-dose melphalan followed by autologous HCT (AHCT) were randomized to receive either true or sham acupuncture once daily for 5 days starting the day after chemotherapy. Patients and clinical evaluators, but not acupuncturists, were blinded to group assignment. Symptom burden, the primary outcome was assessed with the MD Anderson Symptom Inventory (MDASI) at baseline, during transplantation, and at 15 and 30 days post transplantation. Results: Among 60 participants, true acupuncture produced nonsignificant reductions in overall MDASI core symptom scores and symptom interference scores during transplantation (P = .4 and.3, respectively), at 15 days (P = .10 and.3), and at 30 days posttransplantation (P = .2 and.4) relative to sham. However, true acupuncture was significantly more efficacious in reducing nausea, lack of appetite, and drowsiness at 15 days (P = .042,.025, and.010, respectively). Patients receiving sham acupuncture were more likely to increase pain medication use posttransplantation (odds ratio 5.31, P = .017). Conclusions: Acupuncture was well tolerated with few attributable adverse events. True acupuncture may prevent escalation of symptoms including nausea, lack of appetite, and drowsiness experienced by patients undergoing AHCT, and reduce the use of pain medications. These findings need to be confirmed in a future definitive study. Trial registration: NCT01811862.
AB - Purpose: Hematopoietic stem cell transplantation (HCT) is potentially curative for a number of hematologic malignancies, but is associated with high symptom burden. We conducted a randomized sham-controlled trial (RCT) to evaluate efficacy and safety of acupuncture as an integrative treatment for managing common symptoms during HCT. Methods: Adult patients with multiple myeloma undergoing high-dose melphalan followed by autologous HCT (AHCT) were randomized to receive either true or sham acupuncture once daily for 5 days starting the day after chemotherapy. Patients and clinical evaluators, but not acupuncturists, were blinded to group assignment. Symptom burden, the primary outcome was assessed with the MD Anderson Symptom Inventory (MDASI) at baseline, during transplantation, and at 15 and 30 days post transplantation. Results: Among 60 participants, true acupuncture produced nonsignificant reductions in overall MDASI core symptom scores and symptom interference scores during transplantation (P = .4 and.3, respectively), at 15 days (P = .10 and.3), and at 30 days posttransplantation (P = .2 and.4) relative to sham. However, true acupuncture was significantly more efficacious in reducing nausea, lack of appetite, and drowsiness at 15 days (P = .042,.025, and.010, respectively). Patients receiving sham acupuncture were more likely to increase pain medication use posttransplantation (odds ratio 5.31, P = .017). Conclusions: Acupuncture was well tolerated with few attributable adverse events. True acupuncture may prevent escalation of symptoms including nausea, lack of appetite, and drowsiness experienced by patients undergoing AHCT, and reduce the use of pain medications. These findings need to be confirmed in a future definitive study. Trial registration: NCT01811862.
KW - Acupuncture
KW - Complementary therapies
KW - Hematopoietic stem cell transplantation
KW - Integrative medicine
KW - Multiple myeloma
KW - Symptom management
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U2 - 10.1007/s00520-017-3881-7
DO - 10.1007/s00520-017-3881-7
M3 - Article
C2 - 28920142
AN - SCOPUS:85029590013
SN - 0941-4355
VL - 26
SP - 657
EP - 665
JO - Supportive Care in Cancer
JF - Supportive Care in Cancer
IS - 2
ER -