Inpatient palliative care integrated with transplant care improves patients’ quality of life (QOL) and symptom burden during hematopoietic stem-cell transplant (HCT). We assessed patients’ mood, post-traumatic stress disorder (PTSD) symptoms, and QOL 6 months post-transplant.

We randomly assigned 160 patients with hematologic malignancies who underwent autologous or allogeneic HCT to inpatient palliative care integrated with transplant care (n = 81) or transplant care alone (n = 79). At baseline and 6 months post-transplant, we assessed mood, PTSD symptoms, and QOL with the Hospital Anxiety and Depression Scale and Patient Health Questionnaire, PTSD checklist, and Functional Assessment of Cancer Therapy-Bone Marrow Transplant. To assess symptom burden during HCT, we used the Edmonton Symptom Assessment Scale. We used analysis of covariance while controlling for baseline values to examine intervention effects and conducted causal mediation analyses to examine whether symptom burden or mood during HCT mediated the effect of the intervention on 6-month outcomes.

We enrolled 160 (86%) of 186 potentially eligible patients between August 2014 and January 2016. At 6 months post-transplant, intervention participants reported lower depression symptoms on the Hospital Anxiety and Depression Scale and Patient Health Questionnaire (adjusted mean difference, −1.21 [95% CI, −2.26 to −0.16; P = .024] and −1.63 [95% CI, −3.08 to −0.19; P = .027], respectively) and lower PTSD symptoms (adjusted mean difference, −4.02; 95% CI, −7.18 to −0.86; P = .013), but no difference in QOL or anxiety. Symptom burden and anxiety during HCT hospitalization partially mediated the effect of the intervention on depression and PTSD at 6 months post-transplant.

Inpatient palliative care integrated with transplant care leads to improvements in depression and PTSD symptoms at 6 months post-transplant. Reduction in symptom burden and anxiety during HCT partially accounts for the effect of the intervention on these outcomes.

住院姑息治疗与移植治疗相结合可改善患者的生活质量（QOL）和造血干细胞移植（HCT）期间的症状负担。我们评估了患者的情绪，创伤后应激障碍（PTSD）症状以及移植后6个月的生活质量。

我们随机分配了160例接受过自体或异基因HCT的血液系统恶性肿瘤患者，将其与移植治疗（n = 81）或单独进行移植治疗（n = 79）结合起来进行住院姑息治疗。在基线和移植后6个月，我们通过医院焦虑和抑郁量表和患者健康调查表，PTSD检查表以及癌症治疗骨髓移植的功能评估来评估情绪，PTSD症状和QOL。为了评估HCT期间的症状负担，我们使用了埃德蒙顿症状评估量表。我们在控制基线值的同时使用协方差分析来检查干预效果，并进行了因果关系分析以检查HCT期间的症状负担或情绪是否介导了干预对6个月结局的影响。

我们在2014年8月至2016年1月之间纳入了186例潜在合格患者中的160例（86％）。在移植后6个月，干预参与者在《医院焦虑与抑郁量表》和《患者健康调查表》中报告了较低的抑郁症状（调整后的平均差异为−1.21 [分别为95％CI，-2.26至-0.16；P = .024]和-1.63 [95％CI，-3.08至-0.19；P = .027]）和较低的PTSD症状（调整后的平均差异为-4.02； 95％CI，-7.18至-0.86；P = .013），但生活质量或焦虑无差异。HCT住院期间的症状负担和焦虑在移植后6个月部分介导了干预对抑郁症和PTSD的影响。

住院姑息治疗与移植治疗相结合，可在移植后6个月改善抑郁症和PTSD症状。HCT期间症状负担和焦虑的减轻部分说明了干预对这些结果的影响。