Virtual reality and hypnosis for symptom alleviation before bone marrow procedure

Bone marrow aspiration biopsy (BMAB) commonly causes anxiety in patients, negatively affecting their overall procedural experience. We aimed to evaluate the efficacy of hypnosis and virtual reality (VR) compared to standard-of-care in improving concerns of patients undergoing BMAB. In this exploratory open-label randomized-controlled trial, adult patients undergoing BMAB were randomly assigned to hypnosis, VR, or control. Interventions included a 7-minute prerecorded hypnosis session or immersive VR experience immediately prior to the procedure. Patient concerns were measured using the Measure Yourself Concerns and Wellbeing (MYCAW) questionnaire at baseline (T1), post-intervention (T2), and post-procedure (T3). The primary endpoint was the effect of the interventions on the improvement of patients' concerns score in T1-T2 and T1-T3 periods. Sixty-seven patients were randomly assigned to hypnosis (n = 22), VR (n = 24), or control (n = 21). Mean age was 61 years. Baseline MYCAW score was significantly lower in the control group (3.3 ± 1.7) as compared to both the hypnosis (4.9 ± 1.2) and VR (4.3 ± 1.7) groups (p < 0.001). These scores significantly decreased immediately post-intervention in the VR group compared to control even when considering baseline MYCAW in sensitivity analysis (p = 0.003), though this effect did not persist post-procedure (p = 0.62). Younger, less comorbid and highly absorptive patients derived the largest benefit from VR (p < 0.001). Physiological variables showed no significant differences among groups but there was a non-significant trend of lower doses of sedation in the VR group (p = 0.48) and of higher doses of local anesthesia in the control group (p = 0.13). VR demonstrated an immediate beneficial effect in improving patient concerns before BMAB even after adjustment for baseline differences. These exploratory findings support integrating mind-body interventions into clinical hematology settings but should be interpreted with caution and inform future adequately powered trials.