A pilot randomized clinical trial of a peer support intervention for hematopoietic stem cell transplantation

Clinical Snapshot

Key Findings

• P Value: Not reported

• Effect Size: Small-to-moderate improvements: anxiety d=-0.36 (day 30), d=-0.58 (day 60); depression d=-0.25; QOL d=0.48

• Primary Outcome: Feasibility: 77% enrollment rate, 100% completion of ≥3 sessions. Acceptability: mean CSQ score 3.5/4

• Nnt Or Sensitivity: Not calculated - pilot study focused on feasibility outcomes

• Confidence Interval: Not reported

Clinical Application

High feasibility - telephone-based delivery, trained peer supporters, structured 5-session protocol Highly applicable to Australian HSCT centers; aligns with Cancer Australia supportive care guidelines and could integrate with existing psycho-oncology services Adults undergoing HSCT in tertiary cancer centers with established transplant programs

Abstract

Peer support has been associated with improved patient-reported outcomes (PROs), including reduced psychological distress, among patients undergoing hematopoietic stem cell transplantation (HSCT), but structured interventions are limited. This study assessed the feasibility, acceptability, and preliminary effects of a scalable peer support intervention to reduce psychological distress and enhance quality of life (QOL) post-HSCT. We conducted a pilot randomized clinical trial evaluating the Supporting Transplant Experiences with Peer Program (STEPP), a 5-session, telephone-based intervention delivered by an HSCT survivor offering psychoeducation and coping strategies. Participants were recruited 1 to 2 weeks pre-HSCT admission and randomized to STEPP or usual care. Feasibility was defined as ≥60% enrollment and ≥60% completing ≥3 sessions. Acceptability was assessed using the Client Satisfaction Questionnaire (CSQ; ≥3/4 mean benchmark). PRO measures of anxiety, depression (Hospital Anxiety and Depression Scale), posttraumatic stress (Post-Traumatic Stress Disorder Checklist-Civilian Version), QOL (Functional Assessment of Cancer Therapy-Bone Marrow Transplant), social support (Social Support and Effectiveness Questionnaire), and self-efficacy (Cancer Self-Efficacy Scale) were assessed pre-HSCT and at 30 and 60 days post-HSCT. Mixed-effects models explored preliminary effects. We enrolled 77% (90 of 117) of eligible patients (STEPP, n = 45; usual care, n = 45); 12 became ineligible due to HSCT cancellation or postponement. Among 78 active participants (mean age, 58.9 years [standard deviation, 12.3]; 57.7% women), all STEPP participants completed ≥3 sessions, and the mean CSQ score was 3.5. STEPP showed small-to-moderate improvements in day 30 anxiety (d = -0.36) and day 60 anxiety (d = -0.58), depression (d = -0.25), posttraumatic stress (d = -0.28), QOL (d = 0.48), social support (d = 0.36), and self-efficacy (d = 0.46). STEPP exceeds feasibility and acceptability thresholds, showing promising psychosocial benefits warranting a fully powered multisite efficacy trial. This trial was registered at www.clinicaltrials.gov as NCT06010017.

References

1. 1.Amonoo, H. L., Keane, E. P., Guo, M., Gudenkauf, L. M., Boardman, A. C., Larizza, I. S., Wolfe, E. D., Mate-Kole, M. N., Healy, B. C., Cutler, C., Jim, H. S., Lee, S. J., Greer, J. A., Huffman, J. C., & El-Jawahri, A. (2026). A pilot randomized clinical trial of a peer support intervention for hematopoietic stem cell transplantation. Blood Advances. https://doi.org/10.1182/bloodadvances.2025018918