Supportive Care Interventions in Hematopoietic Stem Cell Transplantation: Systematic Review and Meta-Analysis

There is no comprehensive synthesis of supportive care interventions for patients with hematologic malignancies receiving transplantation and cellular therapies (TCTs). This systematic review and meta-analysis aimed to characterize randomized controlled trials (RCTs) of TCT supportive care interventions and examine effects on patient-reported outcomes (PROs). We systematically searched MEDLINE, Embase, CINAHL, PsycInfo, Web of Science, and CENTRAL databases. We used the Cochrane Risk of Bias 2.0 protocol, grouped findings by intervention and PRO types, and synthesized results narratively. We conducted exploratory random-effects meta-analyses to estimate pooled intervention effects on anxiety, depression, and quality of life (QOL). Fifty-three RCTs published from 1992 to 2025 met criteria. All RCTs included hematopoietic stem cell transplantation (HSCT) recipients; none were tested in patients receiving cellular therapies. Included studies reported a range of sample sizes (11-711), participant demographics (mean age 33-63 years; 22-64% female), and PROs. There were nine intervention categories: cognitive behavioral (n=5), exercise only (n=17), expressive helping (n=2), mind-body/stress management (n=7), multimodal (exercise plus another modality; n=6), music/art (n=12), palliative care (n=2), positive psychology (n=1), and self-management/self-efficacy (n=5). Interventions were mostly feasible and acceptable, with promising improvements in psychological distress, QOL, and physical outcomes. Meta-analysis showed non-significant trends toward exercise interventions improving QOL (SMD=0.09; 95% CI: -0.07 to 0.25) and music/art interventions reducing acute depressive symptoms (SMD=-0.26; 95% CI: -0.52 to 0.00). Among patients undergoing HSCT for hematologic malignancies, supportive care interventions show feasibility, acceptability, and promise for improving PROs. However, larger, rigorously designed trials using standardized PRO measures are needed to establish efficacy.