P0299 - Safety and acceptance of acupuncture and acupressure in children and adolescents undergoing hematopoietic stem cell transplant

Background
Hematopoietic stem cell transplant (HSCT) is associated with significant morbidity and high symptom burden including mucositis pain, nausea, and vomiting. In adults undergoing HSCT and children receiving chemotherapy, acupuncture has shown efficacy in reducing side effects such as nausea and vomiting. There is little documentation in the literature regarding acupuncture or acupressure for children undergoing HSCT. The purpose of this study was to determine the safety and acceptance of acupuncture and acupressure in children undergoing HSCT in a large tertiary care children’s hospital.

Methods
This is a descriptive retrospective study that evaluated 80 admissions to the HSCT unit over a 24-month period between May 2017 and May 2019. Every child admitted for HSCT was offered acupuncture or acupressure for advanced symptom management by a Chinese medicine doctor who is part of the palliative care program at the institution. Following IRB approval, data were collected using retrospective chart review regarding acceptance and safety of acupuncture and or acupressure, as well as pertinent demographic information for each admission during that time period.

Results
Of the 80 patients reviewed, 46 were male with ages ranging from 0-32 years (mean of 8). Diagnoses include leukemia/ lymphoma (n=), sickle cell disease (N=), aplastic anemia, neuroblastoma, and other metabolic or hematologic disorders. Both allogenic (n=55) and autologous (n=22) were represented. Sixty-six (82.5%) agreed to treatment with acupuncture (n=12), acupressure (n=47) or both (n=6). Patients received a mean of 5.92 total treatments over their admission and a mean of 2.56 in the first 4 weeks following transplant. There were no adverse effects or safety concerns noted, despite the presence of thrombocytopenia that is typical immediately following HSCT. Issues addressed by acupuncture or acupressure included pain from mucositis, nausea, constipation, diarrhea, anxiety, insomnia, and general wellness or healing.

Conclusions
This study demonstrates that acupuncture and acupressure are well accepted by children and their families admitted for HSCT, and is safe even when performed in the first 4 weeks following transplant when the patient is likely to have thrombocytopenia.