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Seven clinical studies

Haematology

STUDY DETAILS

WHAT Evaluate the effects of live music on patients during their stay in the Transplant Unit (autologous haematopoietic stem cell transplant: cohort study).

WHO Principal investigator, Dr. Joaquín Martínez López, head of the Haematology Department at Hospital 12 de Octubre.

WHY Autologous haematopoietic stem cell transplantation (aHSCT) is a common intervention in the treatment of haematological malignancies, such as lymphoma or multiple myeloma. During this stage, patients are exposed to intensive induction chemotherapies, which can produce severe toxicities that can affect multiple organs. The most common adverse events include asthenia, anorexia, prolonged cytopenias, fever and mucositis 1, 2 . The deterioration of their physical condition, as well as prolonged isolation, often cause anxiety disorders and depression 3, 4 .

According to the Spanish National Transplant Organisation (“Organización Nacional de Transplantes”—“ONT”—in Spanish) and the EBMT (European Group for Blood and Marrow Transplantation), in 2017, 3,321 haematopoietic stem cell transplants (HSCTs) were performed in Spain, of which 2,084 were autologous. The first indication for autologous transplant is myeloma, followed by Non-Hodgkin’s and Hodgkin’s lymphoma 5 .

Numerous studies have attempted to shed light on therapies that can improve the quality of life of patients during their stay in hospital. Music has been studied in a population subjected to both autologous and allogeneic HSCT, suggesting benefits in psychological well-being and pain perception 6, 7, 8 . Additionally, the differences between live music and recorded music have been studied, with the former having reduced anxiety most according to self-administered patient questionnaires 9 .

HOW Based on the hypotheses reflected in the Cochrane review and recent results in haematopoietic transplant units, this study sought to assess the effect on blood pressure and heart rate before and after intervention, with the patients themselves acting as controls,

and to evaluate the state of anxiety using the STAI-E form, which the patients answered at different moments during their stay: day of admission, day of infusion, and day 7 of transplant.

CHARACTERISTICS OF THE SERVICE

Situation of the patients

Patients admitted to the Haematology ward, in 4 beds in isolation.

They were patients with MM (multiple myeloma) and NHL (non-Hodgkin’s lymphoma) admitted for autologous haematopoietic stem cell transplantation. They listened to piano music 5 days a week for half an hour, always at the same time, around one in the afternoon, from Monday to Friday.

The space

A piano was placed in a corridor of the Haematology floor so that it could be heard from the rooms.

“Half an hour a day of live music in patients undergoing bone marrow transplant improves their tolerance to treatment and their quality of life”

Dr. Joaquín Martínez López

OBJECTIVES

Main objectives

  • Assess the effect on blood pressure and heart rate.
  • Assess the effect on nausea and antiemetic medication.
  • Determine the effect on the duration of neutropenia.
  • Determine the effect on the severity of mucositis.
  • Anxiety assessment using the STAI-1 form and recording of anxiolytic treatment.
  • Pain assessment by recording analgesia and visual analogue scale (VAS) (0-10).

Secondary objectives

  • Evaluate the effect on humour and entertainment in patients and relatives.

CONCLUSIONS

Although these preliminary results are not clinically relevant at present due to the limitation of the small size of the sample (n = 27), they may be promising for improving the psychological well-being of patients. For this reason, it would be necessary to continue the study in order to achieve clinical significance. The control group for this measurement would be the patients admitted during the months in which there is no musical intervention. Once the study has been completed, the data on graft, mucositis, analgesia and rescue antiemetics will be analysed with respect to a historical control group of patients.