1
|
Button E, Carter H, Gavin NC, LeBlanc TW, McCaffrey N. A systematic review of health state utility values for older people with acute myeloid leukaemia. Qual Life Res 2024:10.1007/s11136-024-03734-9. [PMID: 39172308 DOI: 10.1007/s11136-024-03734-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/07/2024] [Indexed: 08/23/2024]
Abstract
PURPOSE Older people with acute myeloid leukaemia (AML) have a poor prognosis, reduced health-related quality of life (HRQoL) and require substantial healthcare resources. The objectives of this systematic review were to determine what health state utility values (HSUVs) are reported in the literature that can be used in economic evaluations of interventions for older people with AML, identify research gaps, and discuss directions for future research. METHODS The following databases were searched for studies published from inception until Feb 2023: PubMed, EMBASE, CINAHL, PsycINFO, Cochrane, and EconLit. Studies were included if they reported on HSUVs of people with AML >60 years, or HRQoL data that could be mapped to HSUVs using currently published algorithms. RESULTS Of 532 studies identified, 7 met inclusion (4 full studies and 3 conference abstracts). Twenty-eight potentially eligible studies were excluded as they did not report HRQoL measures in sufficient detail to be mapped to utility values. Included studies reported on health states of newly diagnosed disease (n=4 studies), intensive therapy (n=1 study), controlled remission (n=3 studies), and relapsed or refractory disease (n=2 studies). No studies reported on low intensity therapy or supportive care health states. Utility values were largely reported via the EuroQol and ranged from 0.535 (intensive therapy) to 0.834 (controlled remission). CONCLUSION There are gaps in knowledge on HSUVs for older people with AML, particularly for certain treatment-related health states. Future articles should publish comprehensive HRQoL outcomes to enable use in economic evaluation.
Collapse
Affiliation(s)
- Elise Button
- Centre for Healthcare Transformation, Cancer and Palliative Care Outcomes, Queensland University of Technology, Level 7, Q Block, 66 Must Avenue, Kelvin Grove, Brisbane, QLD, Australia.
| | - Hannah Carter
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
| | - Nicole C Gavin
- Cancer Care Services, Metro North Hospital and Health Services, Queensland Health Brisbane, Brisbane, QLD, Australia
| | | | - Nikki McCaffrey
- Deakin Health Economics, School of Health and Social Development, Deakin University, Melbourne, VIC, Australia
| |
Collapse
|
2
|
Hari VG, Nallathambi N, Y V, A K, Naidu SP. The Clinical Profile of Newly Diagnosed Acute Myeloid Leukemia at a Tertiary Care Center in South India: A Cross-Sectional Study. Cureus 2024; 16:e61234. [PMID: 38939268 PMCID: PMC11210435 DOI: 10.7759/cureus.61234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/27/2024] [Indexed: 06/29/2024] Open
Abstract
Background and objective Acute myeloid leukemia (AML) is a heterogeneous and aggressive blood malignancy prevalent among both children and adults, accounting for a significant proportion of acute leukemia cases worldwide. Our study aimed to shed light on the demographic and clinical profile and risk stratification of newly diagnosed AML cases at a tertiary care government hospital in South India. Methods We conducted a cross-sectional study involving 221 patients with AML in the Department of Clinical Hematology, Rajiv Gandhi Government General Hospital and Madras Medical College, Chennai, Tamil Nadu from January 2020 to December 2022. All data were collected from the hospital database of patients' medical records. A thorough analysis of clinical history, comorbidities, laboratories, risk stratification, and chemotherapy regimen was performed. The patients included in the study were newly diagnosed cases of AML over the age of 13 years, and we excluded all the relapsed cases. Results The highest proportion of patients were in the age group of 41-50 years (22.2%), and there was a significant male predominance (55.7%) in the cohort. Occupationwise, 31% of the study population were farmers, followed by housewives (16.3%). While no identifiable risk factors for AML were found in 191 cases (86.4%), 4.1% had undergone previous chemotherapy, and 3.6% had myelodysplastic syndrome (MDS). Hyperuricemia was noted in 50 cases (22.6%) while 8.6% had tumor lysis syndrome (TLS). About 53.8% of cases fell in the intermediate risk category of AML. Standard induction chemotherapy was administered in 87.3% of cases of AML. Conclusions Gaining awareness and knowledge about the regional demographic data and clinical presentation of AML will aid in the early detection, prompt referral, and initiation of treatment, thereby further improving patient outcomes in the era of targeted therapy and hematopoietic stem cell transplantation.
Collapse
Affiliation(s)
- Vandana G Hari
- Clinical Hematology, Madras Medical College, Chennai, IND
| | | | - Vikram Y
- Hematology, Madras Medical College, Chennai, IND
| | | | | |
Collapse
|
3
|
Muffly L, Young C, Feng Q, Nimke D, Pandya BJ. Healthcare resource utilization and costs during first salvage therapy for relapsed or refractory acute myeloid leukemia in the United States. Leuk Lymphoma 2023; 64:1832-1839. [PMID: 37486091 DOI: 10.1080/10428194.2023.2235044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 06/30/2023] [Accepted: 07/05/2023] [Indexed: 07/25/2023]
Abstract
Real-world US healthcare resource utilization (HRU) and costs during first salvage therapy for relapsed/refractory (R/R) acute myeloid leukemia (AML) are described using IBM MarketScan® data (1/1/2007-6/30/2020). Treatments included high- (HIC) and low-intensity chemotherapy (LIC) alone, and gilteritinib, other FLT3 tyrosine kinase inhibitors (TKIs), and venetoclax with or without chemotherapy. Patients were diagnosed with R/R AML at ≥18 years of age between 1/1/2017-12/31/2019. Patient monthly all-cause HRU and costs were analyzed using a fixed-effects model. Data from 399 patients were analyzed (HIC, n = 104; LIC, n = 133; gilteritinib, n = 14; other FLT3 TKIs, n = 68; venetoclax, n = 80). Inpatient HRU was generally highest with HIC, whereas outpatient HRU was generally highest with LIC and venetoclax. Total all-cause incremental monthly costs appeared to be highest with HIC ($171,982) and similar for LIC ($60,512), gilteritinib ($47,218), other FLT3 TKIs ($43,218), and venetoclax ($77,566). Results highlight HRU and cost differences for R/R AML during first salvage therapy.
Collapse
Affiliation(s)
- Lori Muffly
- Division of Blood and Marrow Transplantation and Cellular Therapy, Stanford University, Stanford, CA, USA
| | | | - Qi Feng
- Astellas Pharma, Inc, Northbrook, IL, USA
| | | | | |
Collapse
|
4
|
Brunner AM, Huggar D, Copher R, Zhou ZY, Zichlin ML, Anderson A, Downes N, McBride A. Economic burden during remission and after relapse among older patients with newly diagnosed acute myeloid leukemia without hematopoietic stem cell transplant: A retrospective study using the SEER-Medicare database. Leuk Res 2023; 132:107353. [PMID: 37562330 DOI: 10.1016/j.leukres.2023.107353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 06/13/2023] [Accepted: 07/08/2023] [Indexed: 08/12/2023]
Abstract
Acute myeloid leukemia (AML) is associated with a substantial clinical and economic burden. This study characterized the magnitude of this burden following initial treatment with standard or less intensive therapies (hypomethylating agents [HMAs]) and throughout different treatment phases post-remission. The Surveillance, Epidemiology, and End Results (SEER) cancer registry (2007-2016) linked with Medicare beneficiary claims (2007-2015) was analyzed. Patients were ≥ 65 years old with AML who initiated chemotherapy or HMAs and achieved remission. Outcomes included baseline characteristics, treatment patterns, clinical outcomes, healthcare resource utilization (HRU), and costs (2019 United States dollar). Economic impacts were stratified by treatment phase (initial treatment, early post-remission, late post-remission, and post-relapse). Early and late post-remission were defined as treatment initiated ≤ 60 days and > 60 days following initial treatment, respectively. A subgroup analysis of patients receiving only HMAs as initial treatment was also conducted. Overall, 530 patients were included (mean age: 74.1 years; 53.6 % male). In the overall analysis, 68.1 % of patients received post-remission treatment; 31.9% had no post-remission treatment. Mean monthly per patient healthcare costs by treatment phase were $45,747 (initial treatment), $30,248 (early post-remission), $23,173 (late post-remission), and $37,736 (post-relapse), driven predominantly by inpatient visits. The HMA subgroup analysis comprised 71 patients (mean age: 78.8 years; 50.7 % male); mean monthly per patient healthcare costs were highest post-relapse. The economic burden of AML among older patients is substantial across all treatment phases. AML treatments that induce and prolong remission may reduce HRU and the economic burden of disease.
Collapse
|
5
|
Wei Z, Su L, Gao S. The roles of ubiquitination in AML. Ann Hematol 2023:10.1007/s00277-023-05415-y. [PMID: 37603061 DOI: 10.1007/s00277-023-05415-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 08/10/2023] [Indexed: 08/22/2023]
Abstract
Acute myeloid leukemia (AML) is a heterogeneously malignant disorder resulting in poor prognosis. Ubiquitination, a major post-translational modification (PTM), plays an essential role in regulating various cellular processes and determining cell fate. Despite these initial insights, the precise role of ubiquitination in AML pathogenesis and treatment remains largely unknown. In order to address this knowledge gap, we explore the relationship between ubiquitination and AML from the perspectives of signal transduction, cell differentiation, and cell cycle control; and try to find out how this relationship can be utilized to inform new therapeutic strategies for AML patients.
Collapse
Affiliation(s)
- Zhifeng Wei
- Department of Hematology, The First Hospital of Jilin University, Changchun, China
| | - Long Su
- Department of Hematology, The First Hospital of Jilin University, Changchun, China
| | - Sujun Gao
- Department of Hematology, The First Hospital of Jilin University, Changchun, China.
| |
Collapse
|
6
|
Genç EE, Saraç İS, Arslan H, Eşkazan AE. Diagnostic and Treatment Obstacles in Acute Myeloid Leukemia: Social, Operational, and Financial. Oncol Ther 2023:10.1007/s40487-023-00229-4. [PMID: 37178373 PMCID: PMC10182356 DOI: 10.1007/s40487-023-00229-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 04/06/2023] [Indexed: 05/15/2023] Open
Abstract
Acute myeloid leukemia (AML) can affect individuals of all ages, but is more common in older adults. It has been estimated that AML accounted for 1% of all newly diagnosed cancers in the USA in 2022. The diagnostic process varies depending on the presenting symptoms and the healthcare facility that patients attend at diagnosis. The treatment process is long and prone to complications, requiring experienced medical professionals and appropriate infrastructure. Treatment of the disease did not change greatly over the years until 2017 when targeted therapies were licensed. The treatment of AML is associated with significant direct economic costs. A number of obstacles originating both from individual patients and the healthcare system may be encountered during the diagnosis and treatment of the disease, which may negatively impact the optimal management of the disease process. In this article, we focus primarily on the social, operational, and financial obstacles including the corona virus disease 2019 (COVID-19) pandemic experienced during the diagnosis and treatment of AML.
Collapse
Affiliation(s)
- Emine Eylem Genç
- Department of Hematology, Tekirdağ Dr. Ismail Fehmi Cumalıoğlu State Hospital, Tekirdağ, Turkey
| | - İrem Sena Saraç
- Cerrahpaşa Faculty of Medicine, Istanbul University-Cerrahpaşa, Istanbul, Turkey
| | - Hayrunnisa Arslan
- Cerrahpaşa Faculty of Medicine, Istanbul University-Cerrahpaşa, Istanbul, Turkey
| | - Ahmet Emre Eşkazan
- Division of Hematology, Department of Internal Medicine, Cerrahpaşa Faculty of Medicine, Istanbul University-Cerrahpaşa, Fatih, Istanbul, Turkey.
| |
Collapse
|
7
|
Feld J, Tremblay D, Navada SC, Silverman LR. Ascertaining QUAZARs: slow-motion and light-speed development of oral azacitidine and decitabine. Leuk Lymphoma 2023; 64:525-539. [PMID: 36370098 DOI: 10.1080/10428194.2022.2142051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Myelodysplastic syndromes (MDS) and acute myeloid leukemia (AML) are devastating diseases that frequently rely on the use of parenteral hypomethylating agents (HMAs), either as monotherapy or in combination, as first-line treatment for many patients. Two new oral HMAs, decitabine/cedazuridine (DC) for use in place of azacitidine or decitabine in MDS, and azacitidine (CC-486) for use as maintenance treatment in AML, were recently approved by the FDA. We will discuss the development of these oral HMAs, including the advantages/disadvantages in transitioning to oral HMAs and an in depth look at the pivotal phase III trials that led to their FDA approval - ASCERTAIN for DC and QUAZAR-AML-001 for CC-486. We also review how these agents have been and are being studied in other malignancies, and examine the future role that these exciting novel agents will play in both MDS and AML.
Collapse
Affiliation(s)
- Jonathan Feld
- Division of Hematology/Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Douglas Tremblay
- Division of Hematology/Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Shyamala C Navada
- Division of Hematology/Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Lewis R Silverman
- Division of Hematology/Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| |
Collapse
|
8
|
Muacevic A, Adler JR, Patel AM, Thoutam HR, Yasmeen S, Jarrad AA, Kaur G, Patel V. Utilization of Hematopoietic Stem Cell Transplantation for Acute Myeloid Leukemia and Related Hospital Outcomes: A Cross-Sectional Study of US Hospitals. Cureus 2022; 14:e32821. [PMID: 36694524 PMCID: PMC9863731 DOI: 10.7759/cureus.32821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/22/2022] [Indexed: 12/24/2022] Open
Abstract
Background In this study, we aimed to provide a descriptive overview of the utilization of hematopoietic stem cell transplantation (HSCT) for the treatment of acute myeloid leukemia (AML), determine the rates of HSCT use stratified by patients' demographic characteristics, and measure the hospitalization outcomes. Methodology We conducted a cross-sectional study using the Nationwide Inpatient Sample (NIS) obtained from hospitals in the United States. Our sample included 21,385 adult patients (aged ≥18 years) with a primary discharge diagnosis of AML. The sample was further grouped by inpatients who were managed with HSCT and chemotherapy as the primary procedure. We compared the demographic characteristics and hospital outcomes in AML inpatients across treatment cohorts by performing descriptive statistics and Pearson's chi-square test. Next, we measured the differences in continuous variables (length of stay and cost) using the analysis of variance (ANOVA). All analyses were conducted using SPSS version 26 (IBM Corp., Armonk, NY, USA). Results The hospital-based utilization rate of HSCT was 0.4% in AML inpatients. The utilization rate of HSCT was higher in females (0.5%), African Americans (0.6%), those with median household incomes above the 50th percentile (0.5%), and those covered by private insurance (0.8%). A significantly higher proportion of AML inpatients with HSCT had depression (22.2% vs. 11.4% in total). AML inpatients receiving HSCT had significantly longer hospitalization stays and higher treatment costs than those receiving chemotherapy. The all-cause inpatient mortality was 11.6% in AML inpatients. Statistically, there were no significant differences by treatment. Conclusions HSCT appears to be underutilized for the treatment of AML. This treatment had a higher utilization rate in females and those from high-income families and was covered by private insurance. The utilization of chemotherapy and HSCT did not significantly differ in the presence of comorbidities, except for depression and hypertension having a higher utilization of HSCT.
Collapse
|
9
|
Choi M, Song J, Bui CN, Ma E, Chai X, Yin L, Betts KA, Kapustyan T, Montez M, LeBlanc TW. Costs per patient achieving remission with venetoclax-based combinations in newly diagnosed patients with acute myeloid leukemia ineligible for intensive induction chemotherapy. J Manag Care Spec Pharm 2022; 28:980-988. [DOI: 10.18553/jmcp.2022.22021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Affiliation(s)
| | | | | | | | | | - Lei Yin
- Analysis Group, Los Angeles, CA
| | | | | | | | | |
Collapse
|
10
|
Stemler J, de Jonge N, Skoetz N, Sinkó J, Brüggemann RJ, Busca A, Ben-Ami R, Ráčil Z, Piechotta V, Lewis R, Cornely OA. Antifungal prophylaxis in adult patients with acute myeloid leukaemia treated with novel targeted therapies: a systematic review and expert consensus recommendation from the European Hematology Association. THE LANCET HAEMATOLOGY 2022; 9:e361-e373. [DOI: 10.1016/s2352-3026(22)00073-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 02/16/2022] [Accepted: 02/17/2022] [Indexed: 12/24/2022]
|
11
|
Soliman R, Heneghan C, Bolous NS, Sidhom I, Ahmed S, Roberts N, Oke J, Elhaddad A. Systematic review of costs and cost-effectiveness of treatment for relapsed/refractory acute leukaemia in children and young adults. Expert Rev Hematol 2022; 15:345-357. [PMID: 35485262 DOI: 10.1080/17474086.2022.2069096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Survival outcomes of children with relapsed/refractory (r/r) acute leukaemia remain poor. Novel expensive treatments have been developed to improve their outcomes, yet, limited evidence exists about cost-effectiveness of alternative treatment strategies. AREAS COVERED A systematic review was conducted to summarize the health-economic evidence about costs/cost-effectiveness of treating r/r acute leukaemia in children/young adults. We searched Medline, Embase, and Cochrane databases until August 13th, 2021. Eligible articles included peer-reviewed original studies addressing r/r paediatric/young-adult acute lymphoblastic leukaemia (ALL), and acute myeloid leukaemia (AML). Quality assessment was conducted using Consolidated Health Economics Evaluation Reporting Standards (CHEERS) checklist. EXPERT OPINION The majority of papers focused on CAR-T cell therapy, which is still a novel treatment for r/r ALL, and was found to be cost-effective, yet, there remain concerns over its long-term effectiveness, affordability, and equity in access. The next best treatment option is Blinatumomab, followed by Clofarabine therapy, whereas FLA-IDA salvage chemotherapy provides least value for money. The quality of evidence is moderate to high, with limited generalizability of findings due to high variability in outcomes obtained from modelling studies. Limited studies evaluated r/r AML. We provide recommendations to deliver cost-effective treatments in real-world contexts, with implications for healthcare policy and practice.
Collapse
Affiliation(s)
- Ranin Soliman
- Department for Continuing Education, University of Oxford, UK.,Health Economics and Value Unit, Children's Cancer Hospital 57357 Egypt (CCHE), Egypt
| | - Carl Heneghan
- Centre for Evidence Based Medicine, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Nancy S Bolous
- Department of Global Pediatric Medicine, St. Jude Children's Research Hospital, USA
| | - Iman Sidhom
- Department of Pediatric Oncology, Children's Cancer Hospital 57357 Egypt (CCHE), Egypt.,Department of Pediatric Oncology, National Cancer Institute, Cairo University, Egypt
| | - Sonia Ahmed
- Department of Pediatric Oncology, Children's Cancer Hospital 57357 Egypt (CCHE), Egypt.,Department of Pediatric Oncology, National Cancer Institute, Cairo University, Egypt
| | - Nia Roberts
- Oxford Bodleian Health Care Libraries, University of Oxford, Oxford, UK
| | - Jason Oke
- Centre for Evidence Based Medicine, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Alaa Elhaddad
- Department of Pediatric Oncology, Children's Cancer Hospital 57357 Egypt (CCHE), Egypt.,Department of Pediatric Oncology, National Cancer Institute, Cairo University, Egypt
| |
Collapse
|
12
|
Acute Myeloid Leukemia-Related Proteins Modified by Ubiquitin and Ubiquitin-like Proteins. Int J Mol Sci 2022; 23:ijms23010514. [PMID: 35008940 PMCID: PMC8745615 DOI: 10.3390/ijms23010514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 12/24/2021] [Accepted: 12/30/2021] [Indexed: 11/17/2022] Open
Abstract
Acute myeloid leukemia (AML), the most common form of an acute leukemia, is a malignant disorder of stem cell precursors of the myeloid lineage. Ubiquitination is one of the post-translational modifications (PTMs), and the ubiquitin-like proteins (Ubls; SUMO, NEDD8, and ISG15) play a critical role in various cellular processes, including autophagy, cell-cycle control, DNA repair, signal transduction, and transcription. Also, the importance of Ubls in AML is increasing, with the growing research defining the effect of Ubls in AML. Numerous studies have actively reported that AML-related mutated proteins are linked to Ub and Ubls. The current review discusses the roles of proteins associated with protein ubiquitination, modifications by Ubls in AML, and substrates that can be applied for therapeutic targets in AML.
Collapse
|
13
|
Ghaljaei F, Jalalodini A. The effects of foot reflexology on pain and physiological indicators in children with leukemia under chemotherapy: a clinical trial study. Rep Pract Oncol Radiother 2021; 26:955-961. [PMID: 34992868 PMCID: PMC8726439 DOI: 10.5603/rpor.a2021.0116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 10/28/2021] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Foot reflexology is a popular complementary medicine method; however, previous studies have shown conflicting results. This study aimed to investigate the impact of foot reflexology on pain and physiological responses caused by intrathecal injection of chemotherapy drugs in children with leukemia. MATERIALS AND METHODS This clinical trial included 80 children with leukemia. The participants received 20 min foot reflexology (10 min each foot). The primary measured outcomes included pain and physiological indicators (blood pressure and heart rate). RESULTS The results showed that foot reflexology had a significant effect on reducing pain (p = 0.002) and improving physiological indicators [blood pressure (p = 0.002) and heart rate (p = 0.003)]. CONCLUSION Based on the results of the present study, which shows the positive effect of foot reflexology on the improvement of pain and physiological indicators, foot reflexology can be used as a complementary treatment along with conventional therapies.
Collapse
Affiliation(s)
- Fereshteh Ghaljaei
- Department of Pediatric Nursing, School of Nursing and Midwifery, Community Nursing Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Alia Jalalodini
- Department of Nursing, School of Nursing and Midwifery, Zahedan University of Medical Sciences, Zahedan, Iran
| |
Collapse
|