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Acupuncture for reduction of symptom burden in multiple myeloma patients undergoing autologous hematopoietic stem cell transplantation: a randomized sham-controlled trial

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Abstract

Purpose

Hematopoietic stem cell transplantation (HCT) is potentially curative for a number of hematologic malignancies, but is associated with high symptom burden. We conducted a randomized sham-controlled trial (RCT) to evaluate efficacy and safety of acupuncture as an integrative treatment for managing common symptoms during HCT.

Methods

Adult patients with multiple myeloma undergoing high-dose melphalan followed by autologous HCT (AHCT) were randomized to receive either true or sham acupuncture once daily for 5 days starting the day after chemotherapy. Patients and clinical evaluators, but not acupuncturists, were blinded to group assignment. Symptom burden, the primary outcome was assessed with the MD Anderson Symptom Inventory (MDASI) at baseline, during transplantation, and at 15 and 30 days post transplantation.

Results

Among 60 participants, true acupuncture produced nonsignificant reductions in overall MDASI core symptom scores and symptom interference scores during transplantation (P = .4 and .3, respectively), at 15 days (P = .10 and .3), and at 30 days posttransplantation (P = .2 and .4) relative to sham. However, true acupuncture was significantly more efficacious in reducing nausea, lack of appetite, and drowsiness at 15 days (P = .042, .025, and .010, respectively). Patients receiving sham acupuncture were more likely to increase pain medication use posttransplantation (odds ratio 5.31, P = .017).

Conclusions

Acupuncture was well tolerated with few attributable adverse events. True acupuncture may prevent escalation of symptoms including nausea, lack of appetite, and drowsiness experienced by patients undergoing AHCT, and reduce the use of pain medications. These findings need to be confirmed in a future definitive study.

Trial registration

NCT01811862

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Funding

The study was funded by a grant from the Gateway for Cancer Research, and the MSK Integrative Medicine and Translational Research Grant. We also received support from the National Institutes of Health/National Cancer Institute (NIH/NCI) Cancer Center Support Grant P30 CA008748, the AC Israel Foundation, and the Byrne Fund.

Author information

Authors and Affiliations

  1. Integrative Medicine Service, Memorial Sloan Kettering Cancer Center, 1429 First Avenue, New York, NY, 10021, USA

    Gary Deng, Jonathan Siman, Benjamin Search, Marci Coleton, Barrie Cassileth & Jun J. Mao

  2. Bone Marrow Transplantation Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Sergio Giralt, David J. Chung & Heather Landau

  3. Health Outcomes Research Group, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Emily Vertosick, Nathan Shapiro & Christine Chien

  4. Department of Symptom Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Xin S. Wang

Authors
  1. Gary Deng
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  2. Sergio Giralt
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  3. David J. Chung
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  4. Heather Landau
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  5. Jonathan Siman
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  6. Benjamin Search
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  7. Marci Coleton
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  10. Christine Chien
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  11. Xin S. Wang
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Contributions

We would like to thank Yi Chan, Matthew Weitzman, Theresa Affuso (acupuncturists); Khaula Malik, Kelsi Clement, Jeremy Taylor, Mollie McMahon, Janice DeRito (research study assistants); and Andrew Vickers, PhD (biostatistician) for their work in this study, which was supported by funding from the NIH/NCI Cancer Center Support Grant P30 CA008748. In addition, we thank IH and CS for their help in the preparation and submission of this manuscript, which was also supported by funding from NIH/NCI Cancer Center Support Grant P30 CA008748.

Corresponding author

Correspondence to Gary Deng.

Ethics declarations

This study was approved by the Institutional Review Board (IRB) at Memorial Sloan Kettering Cancer Center. All procedures performed were in accordance with the ethical standards of the institutional research committee.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Conflict of interest

Dr. Giralt has received honoraria from Celgene, Takeda, Amgen, Jazz, and Sanofi; served in a consulting/advisory role for Celgene, Takeda, Sanofi, Jazz, Amgen, and Janssen; received research funding from Celgene and Takeda. Dr. Landau has received honoraria from Takeda; served in a consulting/advisory role for Onyx, Spectrum, Takeda, and Prothena; received research funding from Onyx. The remaining authors declare no competing financial interests.

Role of the funder/sponsor

The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

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Deng, G., Giralt, S., Chung, D.J. et al. Acupuncture for reduction of symptom burden in multiple myeloma patients undergoing autologous hematopoietic stem cell transplantation: a randomized sham-controlled trial. Support Care Cancer 26, 657–665 (2018). https://doi.org/10.1007/s00520-017-3881-7

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  • DOI: https://doi.org/10.1007/s00520-017-3881-7

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