Early Integration of Palliative and Supportive Care for Patients and Family Caregivers Undergoing Hematopoietic Stem Cell Transplantation or Chimeric Antigen Receptor T-Cell Therapy: A Prospective Pragmatic Randomized Clinical Trial

What this Trial Is About

This research aims to evaluate the early integration of palliative and supportive care for patients undergoing hematopoietic stem cell transplantation (HSCT) or chimeric antigen receptor (CAR) T-cell therapy for blood cancers. Patients with these conditions face high symptom burdens and often experience poor end-of-life outcomes compared to those with solid tumors. The study also focuses on the quality of life for family caregivers, recognizing their physical and psychosocial challenges. Participants will be randomly assigned to receive either early outpatient palliative care or standard care. The palliative care intervention includes education and support delivered by a nurse practitioner or physician, focusing on symptom management, advance care planning, prognostic understanding, and coping strategies. Meetings occur one to two times weekly from before treatment until three months after HSCT or CAR T-cell therapy. Standard care follows usual procedures, with palliative care consultations as needed. During the study, patients and caregivers will complete questionnaires at baseline, at specific times shortly after treatment, and at one and three months post-treatment. Data will be collected remotely via secure electronic surveys. Researchers will assess patient quality of life, symptom burden, and understanding of prognosis, as well as caregiver quality of life. Medical records may be accessed for up to five years to gather treatment and disease information. The total participation duration includes follow-up evaluations up to three months post-treatment, with optional longer-term questionnaire completion.

Early Integration of Palliative and Supportive Care in Cellular Therapy