Project Description
Reducing Persistent Fatigue Following Hematopoietic Stem Cell Transplantation
Hematopoietic stem cell transplant (HCT) is a
potentially curative treatment for patients with life-threatening blood
disorders and involves a
prolonged hospitalization. During and after this intensive treatment,
patients are at risk for a host of complications, with as many as 64% of HCT
recipients going on to experience profoundly debilitating fatigue up to six
years post-transplant. This fatigue often persists despite routine medical
intervention, and empirically-tested interventions have been largely
ineffective at managing post-transplant fatigue. Cognitive-behavioral therapy
(CBT) is an evidence-based treatment for fatigue; however, despite the pressing
patient need, CBT for fatigue reduction has not been investigated in the HCT setting.
To address this gap, the
proposed study employs a two-stage design to develop and test a
videoconference, cognitive-behavioral intervention to reduce fatigue and
improve quality of life among persistently fatigued HCT survivors at the
Massachusetts General Hospital Cancer Center. The first aim is to refine the CBT for
fatigue intervention based on acceptability findings from an open pilot study
with a small sample of transplant recipients. The second aim is to determine
the feasibility and preliminary efficacy of the CBT for fatigue intervention
for reducing fatigue and improving quality of life by conducting a pilot
randomized controlled trial. With the essential support of an interdisciplinary team of mentors and
scientific advisors, this project will provide the basis for launching Dr.
Nelson’s career as an independent investigator, with the goal of changing the
paradigm of care for stem cell transplant survivors. Findings could provide a
roadmap for the development and adaptation of fatigue interventions for a broad
variety of cancer and palliative populations.
Bio
Ashley
Nelson is a clinical psychologist in the Department of Psychiatry at the
Massachusetts General Hospital and Harvard Medical School. Dr. Nelson graduated
from the University of Wisconsin with a BA in Psychology and later received her
PhD in Clinical Psychology from the University of South Florida. She completed
her predoctoral internship with the Behavioral Medicine Program at the
Massachusetts General Hospital, and she is currently completing her
postdoctoral fellowship in Oncology Population Sciences at the Dana Farber
Cancer Institute and Harvard Medical School. Her research focuses on
understanding quality of life impairments stemming from a blood disorder
diagnosis and treatment as well as adapting psychosocial interventions to
alleviate physical and emotional side effects and improve quality of life.
Email: ANELSON11@mgh.harvard.edu