Project Summary
This research project is in progress. PCORI will post the research findings on this page within 90 days after the results are final.
What is the research about?
Hematopoietic cell transplantation, or HCT, is commonly known as bone marrow transplant. HCT is the only treatment that can cure advanced blood cancers. Each year 20,000 people have HCT in the United States.
HCT is a complex treatment. Not all hospitals perform it. With HCT, doctors use chemotherapy or radiation to kill cancer cells in bone marrow. Then they replace the patient’s marrow with another person’s cells.
Clinicians, such as doctors and nurses, watch patients closely in the first six months after HCT, while new immune cells take hold. Patients are at risk for infections and graft-versus-host disease, or GVHD. Patients often travel long distances for these visits, which can be time-consuming and costly for patients and caregivers.
This study is comparing two ways to care for patients who have had an HCT. In the first way, the patient’s local cancer doctor and HCT doctor work together to give check-ups and lab tests. In the second way, patients get care from their HCT doctor only.
Who can this research help?
Study results can help HCT centers provide care that will best support patients after bone marrow transplant.
What is the research team doing?
The research team is working with an HCT clinic in Boston to enroll 324 patients who are getting an HCT. Patients live in New England and near one of eight local oncology centers taking part in the study. Doctors at the oncology centers get yearly training and monthly calls with HCT doctors to learn how to care for patients after HCT.
In this study, the research team is assigning patients by chance to one of two groups. In the shared care group, for the first 90 days, patients switch between seeing their local doctor and visiting the HCT clinic each week. At the end of 90 days, alternating visits take place every two to three weeks. HCT doctors and local cancer doctors share a care plan and communicate with each other via a web portal. Patients can view the portal, including contact information for their care teams and details about their treatment. In the usual care group, patients receive all of their post-HCT care at the HCT clinic in Boston.
For six months, the research team is comparing changes in patients’ cancer- and transplant-related quality of life. The team is also looking at whether patients have financial issues after the transplant. Finally, the team is measuring each patient’s chance of dying and of having a serious health problem after the transplant.
Patients and doctors are working with the research team to plan and carry out the study.
Research methods at a glance
| Design Elements | Description |
|---|---|
| Design | Randomized controlled trial |
| Population | 324 participants ages 18 and over, receiving an HCT at the Dana-Farber Inpatient Hospital or Brigham and Women’s Hospital, who live in New York, Maine, New Hampshire, Vermont, Connecticut, Rhode Island, or Massachusetts, can read English, and live less than 1 hour from a local participating center |
| Interventions/ Comparators |
|
| Outcomes |
Primary: transplant and cancer-related quality of life, financial hardship, and 100-day nonrelapse mortality Secondary: overall survival and presence of chronic GVHD |
| 6-month follow-up for primary outcomes |