Orange Interventions for Symptoms Associated With Dimethyl Sulfoxide During Stem Cell Reinfusions...

BACKGROUND:: For over 2 decades, oncology nurses at a regional comprehensive cancer center offered sliced oranges to patients during the reinfusion of autologous hematopoietic progenitor cells (HPCs) to relieve symptoms associated with the preservative dimethyl sulfoxide (DMSO). OBJECTIVES:: This randomized pilot study examined feasibility and efficacy of sliced orange intervention (OI), orange aromatherapy intervention (OAI), or deep breathing (control) to address unpleasant adverse effects during HPC infusion. METHODS:: Orange intervention sniffed or tasted a quartered orange, OAI sniffed orange aromatherapy, and control took deep breaths. Perceived "symptom intensity" for tickle/cough urge, nausea, retching, and perceived "relief" were measured on 0- to 10-point numerical scales. RESULTS:: Sixty of 72 eligible patients consented to participate and were randomized to OI (n = 19), OAI (n = 23), or control (n =18). Study personnel successfully administered study procedures. Over the course of 2 bags of cells infused, the OI group reported significantly greater relief with the intervention (P = .032). Among participants less than 90 kg, OI group reported significantly lower symptom intensity (P = .012). CONCLUSIONS:: Results suggest a feasible protocol and potential efficacy of sliced oranges for treating symptoms associated with DMSO-preserved stem cells. Study procedures provide a tested protocol for future studies. Follow-up study is warranted to confirm these findings and evaluate other treatment options. IMPLICATIONS FOR PRACTICE:: Oranges offer a simple, noninvasive intervention for relieving symptoms associated with DMSO preservative during autologous HPC infusion.

Cancer Nurs. 2011 Mar 2. Potter P, Eisenberg S, Cain KC, Berry DL. Author Affiliations: School of Nursing, University of Portland, Portland, Oregon (Dr Potter); Infusion Services, Seattle Cancer Care Alliance, Seattle, Washington (Mr Eisenberg); Department of Biostatistics and Office for Nursing Research, Seattle, Washington (Dr Cain); Dana-Farber Cancer Institute, Boston, Massachusetts (Dr Berry).