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Self-Care Education Reduces Nausea After SCT For Leukemia

Photo Credit: Klebercordeiro

A mobile app offering treatment and self-care information reduced nausea and vomiting in patients who underwent stem cell transplantation for leukemia.

Self-care education via a smartphone app significantly improved the severity of nausea and vomiting up to three months after stem cell transplantation (SCT) in patients with leukemia, according to study results published in Hematology, Transfusion and Cell Therapy.

"Therefore, this method is recommended to reduce the severity of nausea and vomiting in patients with leukemia who undergo transplantation," wrote corresponding author Zakerimoghadam Masoumeh, PhD, and study coauthors.

The research team developed the app used in the study. The app included information on leukemia and treatments, adverse effects, and self-care for patients. Post-transplant nutrition, infection control, symptom relief, and oral hygiene were specifically addressed, as well as visitation with others during the recovery period.

Researchers tested the app's effect on 104 patients with leukemia undergoing SCT at Shariati Hospital in Tehran in 2019 and 2020. The researchers randomly assigned patients to either an intervention or control group. The former received the educational app and routine care, while the latter received routine care alone. Routine care included a group education session with a lecture before transplantation began.

"A noteworthy point is that patients are discharged from hospitals after the SCT procedure and a 1-month hospitalization process," researchers wrote. "After discharge, patients need to be isolated at home for up to three months, during which time the patients and their caregivers are responsible for monitoring and managing side effects of their treatment."

The researchers evaluated the severity of nausea and vomiting at 2 weeks, 1 month, and 3 months after transplantation via the visual analog scale and the Khavar oncology scale.

Both nausea and vomiting significantly differed between the intervention and control groups at all three timepoints, according to the study. The severity and frequency of vomiting episodes were much lower in the intervention group than in the control group.

"Since vomiting is a common post-transplantation problem that makes eating and drinking difficult for patients, this type of self-care education is recommended to reduce post-transplantation complications and problems for these patients," researchers wrote.

Key Genetic Factors Identified For Predicting Survival For Black Patients With Leukemia

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Researchers at The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC – James) led a global study that identified molecular predictors of survival among Black patients with acute myeloid leukemia (AML). The study suggests a need to modify current AML risk layers by including ancestry-specific genetic factors and testing those in clinical trials.

Co-corresponding authors for study, published in Nature Genetics, are Ann-Kathrin Eisfeld, MD, director of the Clara D. Bloomfield Center for Leukemia Outcomes Research at the OSUCCC – James, and Elaine Mardis, PhD, co-leader of the OSUCCC – James Translational Therapeutics Program.

Study authors note that while many genomic studies over the years have helped scientists classify AML subtypes, the genomic profiles and biomarkers among diverse patients with AML are under studied. This problem has resulted in sustained disparities in survival among patients with this disease.

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Subscribe for FREE "We hope our study highlights the need to have more diversity in clinical studies and subsequent biobanking," said Eisfeld, a hematologist the OSUCCC – James. "There is so much knowledge and improvement in care to be gained for all our patients if we strive toward inclusivity in our efforts. This study is just the first of many steps needed."

The researchers also stated that, in most cancer genomics-based discovery studies to date, including AML, Black patients account for less than 2% of all patients studied, even though Black patients represent 9% of patients with an AML diagnosis.

"The disparity of AML genomic data between ancestry-diverse populations results in the inequitable application of molecular medicine, which increases the potential for inadequate treatment," they wrote. "Previous studies showed that self-reported Black patients with AML have inferior outcomes compared with white patients."

The researchers add that the frequency of genetic mutations and their outcome are different for Black patients with AML.

"The results we've reported are striking and emphasize the role genomics can play in identifying ancestry-specific aspects of cancer onset and outcomes," said Mardis, co-executive director of the Steve and Cindy Rasmussen Institute for Genomic Medicine at Nationwide Children's Hospital. "Our initial results will require genomic profiling of additional Black AML samples, which is underway thanks to National Cancer Institute funding. Ultimately, changing AML risk stratification based on genetic ancestry will require a conclusive clinical trial, but we feel our report strongly supports that likelihood."

Study methods and results In this study, the researchers compared genetic mutation frequencies of 100 Black patients with AML to those of 323 white patients with AML and found that 73% of 162 gene mutations recurrent in Black patients were found in only one white patient or were not detected at all. Other analyses of Black patients found that mutations in NPM1 and NRAS genes were associated with inferior disease-free survival, and mutations in IDH1 and IDH2 genes resulted in reduced overall survival.

Further, inflammatory profiles, cell-type distributions and transcriptional profiles differed between Black and white patients with NPM1 mutations.

When the scientists incorporated these ancestry-specific mutations into the latest European Leukemia Net (an international cooperative research network) genetic risk stratification system, risk group assignment changed for one-third of Black patients, improving their outcome predictions.

This study has shed light on the genomic landscape of AML in Black patients, including the identification of ancestry-associated gene mutations and biological features that differ from traditional European ancestry (white) studies.

Electra Paskett, PhD, deputy director for population sciences and community outreach at the OSUCCC – James, where she also is founding director of the Center for Cancer Health Equity, agrees about the importance of this work.

"This is a landmark study demonstrating the value of including diverse participants in biobanking studies that allow for assessment of genomic factors across race," said Paskett. "In the future, including other levels of influence on outcomes – like individual risk factors, physical and social context and policy factors – will be important to explain differences that are not explained by genetics."

Eisfeld and Mardis say they hope this large-scale study of AML patients with African ancestry will set a precedent for future genomic profiling efforts, "as the current underrepresentation of historically marginalized patient populations constrains our ability to provide the best possible care and limits our understanding of AML biology."

Reference: Stiff A, Fornerod M, Kain BN, et al. Multiomic profiling identifies predictors of survival in African American patients with acute myeloid leukemia. Nat Genet. 2024. Doi: 10.1038/s41588-024-01929-x

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Golden Retriever Therapy Dogs 'bring So Much Light' To Young Girl With Leukemia

A young leukemia patient recently received a special visit from two therapy dogs, and the sweet encounter was shared in an Instagram reel that has gone viral with nearly 10 million views.

In September, golden retrievers Emma and Ellie, both certified therapy dogs, went to see 5-year-old Amara at Children's National Hospital in Washington, D.C., where she has been receiving treatment for leukemia since June.

Amara, a patient at Children's National Hospital, smiles for a photo with Emma, a therapy dog and a golden retriever plush toy.

Courtesy of @EllieGoldenLife

In the video, Amara is seen sweetly interacting with Ellie, doing tricks with her and even showing off a puppet she made.

Amara's mom and stepmom, Trisha and Tayler, told "Good Morning America" Amara hasn't stopped talking about Ellie and Emma since that visit.

Amara with therapy dog Ellie and a golden retriever plush toy.

Courtesy of @EllieGoldenLife

"It truly made her so happy. She tells everyone how sweet they were and how cool their tricks are," they said. "[Ellie and Emma] are so gentle and they truly brought so much light to her life. She was getting prepped for a procedure when they came in to see her, and they helped ease her fears so much."

Playing with dogs could make you happier, study finds

Ellie and Emma are just two of the dogs that are part of Children's National's pet therapy program. Kevin Bubolz, Ellie and Emma's owner and the content creator behind Golden Retriever Life, said he and the golden retrievers do volunteer hospital visits on a weekly basis, giving patients time to meet and pet the therapy dogs, ask questions, and more.

Kevin Bubolz, founder of Golden Retriever Life, with therapy dogs Ellie and Emma and a wagon of plush golden retriever toys.

Courtesy of @EllieGoldenLife

"Pet therapy can have a tremendous impact on the well-being of others," Bubolz said.

Meet the trained dogs for pediatric patients

For other families with children or loved ones in the hospital, Amara's moms said pet therapy can offer a positive respite.

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