Music therapy improves the mood of patients undergoing hematopoietic stem cells transplantation (controlled randomized study).

PURPOSE: The allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a therapeutic medical treatment for various neoplastic hematologic, congenital, genetic, or acquired disorders. In this procedure which combines high-dose chemotherapy and/or radiotherapy and has a high degree of cytotoxicity, the patient experiences solitary confinement, which causes psychological distress, pain, anxiety, mood disorders and can lead him/her to depression. Music therapy was applied with the purpose of decreasing this social confinement. This is a randomized controlled trial. METHOD: Patients (n = 100) were selected randomly. Patients (n = 50) were selected for the Experimental Music Therapy Group (EMG) and n = 50 for the control group (CG) who received the standard treatment. The intervention of live music was applied using music therapy techniques. Assessment and quantification were made using the visual analog scale (VAS). The dependent variables were pain, anxiety, and mood of patients. RESULTS: The Mann-Whitney test (p < 0.05) applied was considered statistically significant when comparing the groups, improving mood significantly (EMG). CONCLUSION: Music therapy proved to be a strong ally in the treatment of patients undergoing allo-HSCT, providing bio-psychosocial welfare.

Unrelated hematopoietic stem cell transplantation in the pediatric population: single institution experience.

OBJECTIVE: Hematopoietic stem cell transplantation has been successfully used to treat the pediatric population with malignant and non-malignant hematological diseases. This paper reports the results up to 180 days after the procedure of all unrelated hematopoietic stem cell transplantations in pediatric patients that were performed in one institution. METHODS: A retrospective review was performed of all under 18-year-old patients who received unrelated transplantations between 1995 and 2009. Data were analyzed using the log-rank test, Cox stepwise model, Kaplan-Meier method, Fine and Gray model and Fisher's exact test. RESULTS: This study included 118 patients (46.8%) who received bone marrow and 134 (53.2%) who received umbilical cord blood transplants. Engraftment occurred in 89.47% of the patients that received bone marrow and 65.83% of those that received umbilical cord blood (p-value<0.001). Both neutrophil and platelet engraftments were faster in the bone marrow group. Acute graft-versus-host disease occurred in 48.6% of the patients without statistically significant differences between the two groups (p-value=0.653). Chronic graft-versus-host disease occurred in 9.2% of the patients with a higher incidence in the bone marrow group (p-value=0.007). Relapse occurred in 24% of the 96 patients with malignant disease with 2-year cumulative incidences of 45% in the bone marrow group and 25% in the umbilical cord blood group (p-value=0.117). Five-year overall survival was 47%, with an average survival time of 1207 days, and no significant differences between the groups (p-value=0.4666). CONCLUSION: Despite delayed engraftment in the umbilical cord blood group, graft-versus-host disease, relapse and survival were similar in both groups.

Long-term outcome and lineage-specific chimerism in 194 patients with Wiskott-Aldrich syndrome treated by hematopoietic cell transplantation in the period 1980-2009: an international collaborative study.

In this retrospective collaborative study, we have analyzed long-term outcome and donor cell engraftment in 194 patients with Wiskott-Aldrich syndrome (WAS) who have been treated by hematopoietic cell transplantation (HCT) in the period 1980- 2009. Overall survival was 84.0% and was even higher (89.1% 5-year survival) for those who received HCT since the year 2000, reflecting recent improvement of outcome after transplantation from mismatched family donors and for patients who received HCT from an unrelated donor at older than 5 years. Patients who went to transplantation in better clinical conditions had a lower rate of post-HCT complications. Retrospective analysis of lineage-specific donor cell engraftment showed that stable full donor chimerism was attained by 72.3% of the patients who survived for at least 1 year after HCT. Mixed chimerism was associated with an increased risk of incomplete reconstitution of lymphocyte count and post-HCT autoimmunity, and myeloid donor cell chimerism < 50% was associated with persistent thrombocytopenia. These observations indicate continuous improvement of outcome after HCT for WAS and may have important implications for the development of novel protocols aiming to obtain full correction of the disease and reduce post-HCT complications.

Grupo de apoio para pacientes e familiares do serviço de transplante de medula óssea / Support group for patients and families at the bone marrow transplantation unit

Esse artigo é um relato da experiência resultante das reflexões pertinentes e aprendizagens originárias nos grupos de pacientes adultos e familiares do ambulatório de Transplante de Medula Óssea. OBJETIVO: Constituir um grupo informativo-reflexivo na sala de espera. MÉTODO: Encontros semanais de uma hora sob a coordenação da psicóloga são ofertados para aqueles que demonstram interesse em trocar experiências e dúvidas. O grupo é aberto, tem novos e antigos participantes. RESULTADO: Os participantes apresentaram preocupações, complacência, medos, fé, alegrias, tristezas nas perdas, ameaças reais e imaginárias. A espera de um doador é dolorosa e incerta e relataram dificuldades em relação ao filho adolescente que cresceu, mas requer vigilância constante. CONCLUSÃO: O grupo funciona como espaço continente das vivências propiciando resultados favoráveis em relação ao bem-estar dos participantes. Pensar sobre as ações e reações perante as adversidades da vida contribui para o aproveitamento dos recursos internos e o enfrentamento dos adventos oriundos do binômio doença-saúde(AU)

This article is an account of the experience obtained from gathering the learning and pertinent reflections originated in the groups of adult patients and family members at the Bone Marrow Transplantation Ambulatory Care Unit. OBJECTIVE: To constitute a reflexive-informative group in the waiting room. METHOD: A weekly group of one-hour meetings under the coordination of a psychologist offered to those who demonstrate interest in exchanging experiences and questions. The group is open to new participants. RESULT: The participants presented worries, complacency, fear, faith, and joy, longing, real and imaginary threats. The wait for a donor is painful and uncertain and it were reported difficulties about the adolescent son who has grown up, but requires constant surveillance. CONCLUSION: The group works as a space for exchange of experiences, improving the well-being of patients. Thinking about the actions and reactions facing the adversities of life contributes to the efficient use of internal resources and helps facing the difficulties arising from the illness-health binomial(AU)