Trial Information

Cognitive Behavioral Intervention for BMT/SCT Survivors: Looking Forward

The use of bone marrow and stem cell transplantation (BMT/SCT) in the treatment of cancer
has increased five-fold over the last decade. Among the cancers treated with BMT/SCT are
Hodgkin's Lymphoma, non-Hodgkin's Lymphoma, multiple myeloma, and leukemias such as acute
lymphoblastic (ALL), acute myelogenous (AML), chronic lymphocytic (CLL), and chronic
myelogenous (CML). With the development of non-myeloablative transplants (either "mini" or
reduced intensity transplants) for patients unable to tolerate standard BMT/SCT, the use of
this procedure is expected to increase substantially over the next five years. BMT/SCT
adversely affects almost every aspect of the patient's life (1;2). A standard (fully
ablative) transplant involves conditioning with dose intensive chemotherapy, with or without
total body irradiation.

Although various medical regimens and supportive psychosocial services are used to reduce
the intensity of these side effects, symptoms may persist. Moreover, the drugs used to
control side effects often have aversive side effects of their own. Thus, patients must
tolerate a protracted course of treatment that is highly aversive and invasive at a time
when their lives are disrupted and they are fearful about their survival. A common complaint
among survivors is that such problems go unaddressed, and these types of adjustment problems
appear to become most intense in the first year post treatment, when physical functioning
has stabilized and contact with the BMT/SCT clinical care team wanes (5;10).