Acute Myeloid Leukemia
Conditions
Keywords
Acute Myeloid Leukemia, Virtual reality, Anxiety, Chemotherapy, Post-traumatic stress, Quality of life, Supportive care
Brief summary
This is a pilot study comparing 3 arms (standard care with hypnosis / standard care with virtual reality / standard care alone), aimed at measuring the effect on anxiety during the induction treatment. Acute myeloid leukemia is considered an oncological emergency that requires chemotherapy treatment with a high risk of serious adverse effects due to prolonged bone marrow failure or drug toxicity. This situation is very stressful for patients, who must cope with the initial symptoms, the diagnosis of a serious cancer, an urgent hospitalization (sometimes in intensive care) and prolonged hospitalization, invasive procedures for diagnosis and initiation of treatment, and intensive chemotherapy requiring protective isolation to contain the risk of life-threatening infection. Added to this care context is the breakdown of family ties as well as socio-professional ties, generating major anxiety and a risk of post-traumatic stress disorder (symptoms, which are common in acute myeloid leukemia. The hypothesis of our study is that hypnosis and virtual reality sessions combined with standard care could reduce anxiety and enhance chemotherapy treatment in acute myeloid leukemia patients when they first learn of their diagnosis.
Detailed description
Patients will be randomly assigned to one of the three arms. All patients will receive standard conventional chemotherapy treatments in accordance with international recommendations and standard conventional care (including supportive care) during their hospital stay. Depending on the group to which they are assigned, they will also participate in hypnotherapy or virtual reality sessions during their hospital stay. Patients will be asked to complete various self-administered questionnaires to measure their levels of anxiety, quality of life, and stress during the course of treatment, according to the study schedule
Interventions
OTHERHypnosis
Each session is based on the hypnosis techniques described by Erickson. In general, a session includes a hypnotic induction phase, a period of deepening and suggestions specific to the symptoms, followed by a return to reality. The hypnotherapist will be someone outside the team, trained in the Ericksonian method, who will intervene at a specific time during the sessions.
OTHERVirtual Reality
Each patient will be able to choose their environment from among those available (forest, beach, Zen garden, scuba diving, winter landscape, northern lights, astral travel, Antarctica, Maldives, desert), accompanied by ambient sounds. During the sessions, patients will be seated in their rooms at a quiet time outside of any treatment.
Sponsors
University Hospital, Toulouse
Association Laurette Fugain
Ligue contre le cancer, France
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patient over the age of 18 * Patient diagnosed with acute myeloid leukemia in Western Occitanie * Eligible for first-line induction chemotherapy with anthracycline and cytarabine * Patient able to understand and respond to a self-administered questionnaire * Affiliated with or beneficiary of a social security system * Having signed the research consent form
Exclusion criteria
* Patients diagnosed with acute myeloid leukemia 3 * Patients who were treated in intensive care prior to hospitalization for induction therapy or following induction therapy * Patients with a diagnosed chronic pain-inducing disease (e.g., rheumatoid arthritis), if not stable * Patients with a confirmed diagnosis of psychopathology such as psychosis, depression, or burnout, if not stable * Patients suffering from epilepsy, whether treated or not, or with a history of epilepsy * Patients under guardianship, conservatorship, or legal protection * Pregnant or breastfeeding women
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Effect of an intervention combining standard care and virtual reality on the anxiety levels of patients at the end of induction chemotherapy for acute myeloid leukemia, compared to standard care and standard care with hypnosis | 35 days | Change in anxiety score, measured using the Hospital Anxiety and Depression Scale |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Effect of an intervention combining standard care and virtual reality, compared to standard care and standard care with hypnosis, on nociceptive pain | 35 days | Pain will be measured using a numerical pain scale at inclusion (first day of hospitalization) |
| Evaluate the effect of an intervention combining standard care and virtual reality, compared to standard care and standard care with hypnosis, on anxiety | 3 months | Change in anxiety scores using the Hospital Anxiety and Depression Scale |
| Evaluate the effect of an intervention combining standard care and virtual reality, compared to standard care and standard care with hypnosis, on quality of life | 3 months | Quality of life scores using the specific Fact-Leu questionnary |
| Evaluate the effect of an intervention combining standard care and virtual reality, compared to standard care and standard care with hypnosis, on post-traumatic stress disorder | 3 months | Post-traumatic stress disorder using the Posttraumatic Stress Disorder Checklist Scale |
| Evaluate the effect of an intervention combining standard care and virtual reality, compared to standard care and standard care with hypnosis, on remission rate | 35 days | Remission rate by sternal puncture, performed systematically (as part of routine care). A blast count of less than 5% will indicate remission |
| Evaluate the effect of an intervention combining standard care and virtual reality, compared to standard care and standard care with hypnosis, on minimal residual disease | 35 days | Minimal Residual Disease, using molecular biology or flow cytometry |
| Evaluate the effect of an intervention combining standard care and virtual reality, compared to standard care and standard care with hypnosis, on consumption of analgesics and psychotropic drugs | 35 days | Medication consumption based on cumulative doses and the number of days on analgesics and psychotropic drugs |
| Evaluate the effect of an intervention combining standard care and virtual reality, compared to standard care and standard care with hypnosis, on occurrence of adverse events related to induction treatment | 35 days | Adverse events related to induction treatment of Common Terminology Criteria for Adverse Events grade ≥ 3, as well as adverse events related to induction treatment such as nausea, vomiting, mucositis, diarrhea, weight loss, and alopecia, regardless of grade |
Countries
France
Contacts
CONTACTSéverine SEAILLES
PRINCIPAL_INVESTIGATORSuzanne TAVITIAN, MD
University Hospital, Toulouse
Outcome results
None listed