Developing Self-Management Interventions After HCT
8 september 2021 bijgewerkt door: University of Florida
Developing the Bio-behavioral Foundation for Self-Management of Psycho-neurological Symptoms in Hematopoietic Cell Transplant (HCT) Survivors
This is a prospective, longitudinal, observational trial to evaluate quality of life in hematopoietic stem cell transplant survivors.
Studie Overzicht
Toestand
Voltooid
Interventie / Behandeling
Gedetailleerde beschrijving
Hematopoietic stem cell transplant (HSCT) survival rates continue to increase as treatment protocols improve.
However, HSCT survivors face many mental, emotional, and physical challenges that threaten quality of life (QOL), which, according to the American Society of Clinical Oncology, is the most important treatment outcome next to survival.
Psychoneurologic symptoms (PNS) significantly diminish QOL after HSCT.
PNS often co-occur and may be associated with inflammation related to perturbations of the gut microbiota.
This project will track the interplay among these factors in 50 adult survivors of HSCT to lay the groundwork for a targeted dietary self-management intervention to mitigate PN symptoms.This is to be achieved by elucidating the complex bio-behavioral mechanisms of distressing symptoms in HCT patients such as neurocognitive dysfunction, fatigue, anxiety, depression and pain, inflammation (cytokines and C-reactive protein), gut microbiota [(GM) richness and diversity] and diet (macronutrients: carbohydrates, fats and proteins).
Studietype
Observationeel
Inschrijving (Werkelijk)
49
Contacten en locaties
In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.
Studie Locaties
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Florida
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Gainesville, Florida, Verenigde Staten, 32608
- UF Health Cancer Hospital
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Deelname Criteria
Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
18 jaar tot 99 jaar (Volwassen, Oudere volwassene)
Accepteert gezonde vrijwilligers
Nee
Geslachten die in aanmerking komen voor studie
Allemaal
Bemonsteringsmethode
Kanssteekproef
Studie Bevolking
Hematopoietic Stem Cell Transplant (HSCT) Survivors.
Survival rates continue to increase as treatment protocols improve; by 2030, an estimated half-million HSCT recipients in the United States will be long-term survivors.
However, HSCT survivors continue to face many mental, emotional, and physical challenges that threaten QOL, which, according to the American Society of Clinical Oncology, is the most important treatment outcome next to survival.
Therefore, a prospective, observational design to longitudinally examine these factors in 50 adult (at least 18 years of age) survivors of HSCT to lay the groundwork for the future development of a targeted dietary self-management intervention to mitigate PN symptoms in this growing group of HSCT survivors is being planned.
Beschrijving
Inclusion Criteria:
- patients scheduled for HSCT with the Bone Marrow Transplant Program at the UF Health Cancer Center (UFHCC) [specifically bone marrow diseases, myelodysplastic-myeloproliferative diseases, lymphoma, bone marrow neoplasm or leukemia]
- Written informed consent obtained from the subject to take Mini-Mental State Examination (MMSE) prior to enrollment on the study and to comply with all the study-related procedures.
- Score at least a 24 on the Mini-Mental State Examination (MMSE) prior to enrollment
Exclusion Criteria:
- Subjects with any of the following will not be eligible for study participation:
- Patient has prior history of HSCT
- Patient has diagnosis that could interfere with neurocognitive function such as dementia, a concurrent diagnosis of systemic lupus erythematous or multiple sclerosis, diagnosis of a major depressive disorder, schizophrenia or untreated bipolar disease.
- Pregnant women are not eligible for transplant therefore will not be enrolled on the study
- Inability to comply with the study and/or follow-up procedures.
Studie plan
Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.
Hoe is de studie opgezet?
Ontwerpdetails
Cohorten en interventies
Groep / Cohort |
Interventie / Behandeling |
|---|---|
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HSCT Survivors
PNS tracking will occur through blood and stool samples to track the interplay among psychoneurologic symptoms (PNS) as they relate to diminished QOL among survivors of HSCT.
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Through blood and stool samples the study team will track the interplay among PNS as they relate to diminished QOL.
Symptoms tracked include neurocognitive dysfunction, fatigue, anxiety, depression and pain, inflammation (cytokines and C-reactive protein), gut microbiota [(GM) richness and diversity] and diet (macronutrients: carbohydrates, fats and proteins).
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Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Change in plasma levels of inflammatory markers (cytokines and CRP) of individuals post allogeneic HSCT
Tijdsspanne: Baseline; Day 30; Day 100
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Cytokines will be analyzed using a multiplex assay by Millipore Company.
Compared to the traditional enzyme-linked immunosorbant assays (ELISA), the multiplex is comparable and more sensitive to lower concentration levels of cytokines than the ELISA.
One laser identifies a specific bead and another laser identifies the reported antibody associated with the bead-bound cytokine.
One hundred beads for each of the 17 cytokines in every sample are assayed and a mean cytokine binding for the sample is determined.
The manufacturer reports that the assay accurately measures cytokine values in a range of 1-2500pg/ml.
Serum CRP will be measured using the ALPCO's (American Laboratory Products Company) high-sensitivity CRP assay which uses latex particle enhanced immunoturbidimetry for quantitative CRP determination.
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Baseline; Day 30; Day 100
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Change in diversity and levels of fecal microbes of individuals post allogeneic HSCT
Tijdsspanne: Baseline; Day 30; Day 100
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Fecal microbial DNA will be extracted from between 50-200 mg of fecal material.
The 16S ribosomal gene (V4 region) of each sample will be amplified using a barcoding system to allow multiplexing with the Illumina MiSeq system.
We will use UNIFRAC algorithm to evaluate the null hypothesis that the structure of the microbial community is insensitive to cGVHD and symptoms of cGVHD.
Differences in taxa are implicated by our high throughput sequencing methods will be confirmed by other techniques including culturing (where appropriate) and qPCR with taxa-specific primers.
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Baseline; Day 30; Day 100
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Change in behavioral responses (symptoms) of individuals post allogeneic HSCT
Tijdsspanne: Baseline; Day 30; Day 100
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Baseline; Day 30; Day 100
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Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Health Promoting Lifestyle Profile II (HPLPII)
Tijdsspanne: Baseline; Day 30; Day 100
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The Health Promoting Lifestyle Profile II (HPLPII) will be used to identify lifestyle choices that may affect relationships and differences between groups.
HPLPII measures health promoting behaviors across several dimensions with subscales of health responsibility, physical activity, nutrition, spiritual growth, interpersonal relations and stress management.
This is a 52-item summated behavior rating scale using a 4-point response format to measure the frequency of self-reported health-promoting behaviors.
It is a well validated toll and takes approximately 10 minutes to complete.
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Baseline; Day 30; Day 100
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Brief Pain Inventory (BPI)
Tijdsspanne: Baseline; Day 30; Day 100
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Pain will be assessed using the Brief Pain Inventory (BPI).
The BPI was created to evaluate two dimensions of pain: 1) the severity and 2) the interference.
This tool is well validated with Cronbach's alpha .80-.87 pain severity and .89-.92 for interference.22
The BPI consists of a body diagram to indicate location of pain and a general question asking if pain is present.
Four items assess pain intensity or severity and seven item s assess pain interference.
Both use an eleven point scale ranging from 0 (no pain or interference) to 10 (worst pain or interference).
This instrument takes approximate five minutes to complete.
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Baseline; Day 30; Day 100
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Hospital Anxiety and Depression Scale (HADS)
Tijdsspanne: Baseline; Day 30; Day 100
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Depressive symptoms will be assessed using the subscale for depression from the Hospital Anxiety and Depression Scale (HADS).
23This instrument is used to assess the presence and severity of anxiety and depressive symptoms over a seven day period.
The depression subscale is comprised of seven items using a four point scale ranging from 0 (least severe) to 3 (most severe).
Cronbach's alpha has been found to be high (.82-.90) for the HADS depression subscale.
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Baseline; Day 30; Day 100
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Brief Fatigue Inventory (BFI)
Tijdsspanne: Baseline; Day 30; Day 100
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Fatigue will be assessed using the Brief Fatigue Inventory (BFI).
The BFI is a nine item, eleven point scale that assesses physical, affective, cognitive and social domains in a two dimensions, fatigue intensity and interference.
Severity scores are as follows: 1) mild (1-3), 2) moderate (4-6) and 3) severe (7-10).
This tool is well establish and validated.
The Cronbach's alpha ranged from .95-.96 for individual items and an internal consistency of .96
overall.
The questionnaire takes approximately five minutes to complete and a global score can be ascertained by averaging the total score.
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Baseline; Day 30; Day 100
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Memorial Symptom Assessment Scale (MSAS-SF)
Tijdsspanne: Baseline; Day 30; Day 100
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To comprehensively explore symptoms, the Memorial Symptom Assessment Scale (MSAS-SF) will be used to measure multiple dimensions (frequency, severity, and distress) of 32 common cancer symptoms.
The Cronbach alpha for the MSAS-SF subscales ranged from .76-.86 and the test-retest correlation coefficients ranged from .86-.94 at one day and one week respectively.
The total time to complete this form is approximately 10 minutes.
This form allows for patients to identify and quantify "other" symptoms.
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Baseline; Day 30; Day 100
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Functional Assessment of Cancer Therapy-Bone Marrow Transplantation (FACT-BMT)
Tijdsspanne: Baseline; Day 30; Day 100
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Health related quality of life (HRQOL) will be measured using the Functional Assessment of Cancer Therapy- Bone Marrow Transplantation (FACT-BMT).
This is a well validated HRQOL measure.
This is a 27-item questionnaire asking questions across four domains: physical well-being, social well-being, emotional well-being and functional well-being.
This measure takes about 10 minutes to complete.
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Baseline; Day 30; Day 100
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Medewerkers en onderzoekers
Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.
Sponsor
Medewerkers
Onderzoekers
- Hoofdonderzoeker: Debra L Kelly, PhD, RN, OCN, College of Nursing, University of Florida
Publicaties en nuttige links
De persoon die verantwoordelijk is voor het invoeren van informatie over het onderzoek stelt deze publicaties vrijwillig ter beschikking. Dit kan gaan over alles wat met het onderzoek te maken heeft.
Studie record data
Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.
Bestudeer belangrijke data
Studie start (Werkelijk)
4 februari 2019
Primaire voltooiing (Werkelijk)
31 juli 2021
Studie voltooiing (Werkelijk)
31 juli 2021
Studieregistratiedata
Eerst ingediend
26 september 2018
Eerst ingediend dat voldeed aan de QC-criteria
16 oktober 2018
Eerst geplaatst (Werkelijk)
17 oktober 2018
Updates van studierecords
Laatste update geplaatst (Werkelijk)
9 september 2021
Laatste update ingediend die voldeed aan QC-criteria
8 september 2021
Laatst geverifieerd
1 september 2021
Meer informatie
Termen gerelateerd aan deze studie
Trefwoorden
Andere studie-ID-nummers
- IRB201802329
- R21NR017749 (Subsidie/contract van de Amerikaanse NIH)
- OCR18772 (Andere identificatie: University of Florida)
Plan Individuele Deelnemersgegevens (IPD)
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ONBESLIST
Informatie over medicijnen en apparaten, studiedocumenten
Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel
Nee
Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct
Nee
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