Effects of expressive helping writing during stem cell transplant: Randomized controlled trial

Area of Science:

• Hematopoietic stem cell transplant (HSCT) survivorship
• Psychosocial oncology
• Intervention research

Background:

• Cancer patients undergoing HSCT frequently experience significant symptom burden and reduced quality of life during the peritransplant period.
• Persistent symptoms post-HSCT can negatively impact long-term outcomes.
• Expressive helping, a brief intervention combining expressive writing and peer support, previously reduced distress in long-term survivors with persistent symptoms.

Purpose of the Study:

• To evaluate the efficacy of expressive helping during the peritransplant period in adult blood cancer patients.
• To determine if early intervention with expressive helping can prevent the development of persistent symptoms and improve quality of life.

Main Methods:

• A randomized controlled trial involving 366 adult blood cancer patients scheduled for HSCT.
• Participants were randomized to complete four sessions of either expressive helping or a neutral writing task.
• Outcomes including symptom severity, distress, quality of life, and fatigue were assessed from prerandomization to 12 months postintervention.

Main Results:

• No statistically or clinically significant differences were observed between the expressive helping group and the control group for primary or secondary outcomes.
• Moderation analyses did not identify any subgroups of participants who particularly benefited from the intervention during the peritransplant period.
• The intervention showed no effect on symptom severity, distress, quality of life, or fatigue.

Conclusions:

• The findings do not support the use of expressive helping during the peritransplant phase of hematopoietic stem cell transplantation.
• It is recommended that cancer survivors with persistent symptoms consider expressive helping at least 9 months posttransplant, based on prior evidence.
• Further research may be needed to identify optimal timing and delivery of psychosocial interventions for HSCT patients.