Description

Each year in France, nearly 2,000 patients, adults and children of all ages, are treated by bone marrow transplantation, the last therapeutic resort to treat and cure serious blood diseases, malignant or not. If this intervention saves more and more lives, it can lead to early or late complications in 50% of patients (graft versus host disease or GvHD in English for Graft versus Host Disease, cardiac and/or metabolic complications, etc.), very disabling on a daily basis and fatal in 25% of cases. The chances of success of the bone marrow transplant are directly correlated to the non-occurrence of these complications.

A mutual influence of psychological health and physical health on the chances of success of the transplant has been highlighted for several years. Simultaneous support of the mind and body based on the 3 pillars - nutritional, psychological, physical - would ensure better preparation for the transplant process for faster recovery after it thanks to the limitation of the occurrence of complications.

However, to date there is no comprehensive support program covering both mental and physical health to help patients overcome the difficulties associated with the transplant and the return to social and professional life.

As part of their care pathway, patients can benefit from sectorized support but it remains incompletely developed, which can generate in patients a feeling of abandonment on the part of the medical team once the cancer treatment is complete.

It is in this context that the digital support solution for transplant patients, called NewSpringForMe, emerged. This project is on the initiative of Professor Régis Peffault de Latour, hematologist-transplanter at Saint-Louis Hospital in Paris. The latter relied on more than 15 years of experience in contact with transplant patients to highlight an unmet need in terms of support. This need is for therapeutic support that complements care, reinforcing it, and making each patient the main actor in his or her quality of life. To fill this gap, the interdisciplinary support tool, NewSpringForMe, combining psychology, nutrition and adapted physical activity, was developed. Thanks to a global management of these three dimensions throughout the transplant process (in the hospital but also in his daily life), NewSpringForMe aims at a better preparation and a more global management of the patient, condition of the best live towards his remission, by making him actor of his course of care.

NewSpringForMe is the first global support system developed in the field of bone marrow transplantation by an entity independent of healthcare structures, thus giving the tool greater accessibility to patients regardless of their prescribing hospital structure.

The innovation of the project is based on comprehensive support for bone marrow transplant patients in three dimensions: psychology, nutrition and physical activity, with the NewSpringForMe digital tool.

Designed around interconnected spaces, NewSpringForMe offers each patient, permanently, according to their needs and at their own pace, a range of tools and therapeutic exercises, complementary to the care provided by the medical and nursing profession, depending on their condition. progress in the transplant process.

• Nature: web platform providing more versatility, flexibility and maneuverability
• Transversality: integrative health for optimized preparation and comprehensive support
• Integration into the care pathway for long-term follow-up

A public health approach: NewSpringForMe's challenge is not only to improve support for patients, but also to keep them healthy throughout their bone marrow transplant experience, thus being part of a optimization of the French healthcare system for better social and professional reintegration.

A therapeutic tool, a place of exchange and sharing, a facilitator of social ties: success is based on the creation of a real dynamic of community of patients and on the increase of knowledge, in order to improve their care.

In order to measure the impact of the use of the NewSpringForMe digital solution, a monocentric pilot phase of evaluation is planned in a cohort of 150 to 200 patients allografted by bone marrow within the hematology transplant department of the Hospital Saint-Louis de Paris (AP-HP).

Recruitment: The NewSpringForMe support solution will be offered directly by the healthcare team (transplant doctor, transplant coordinator, etc.) to the patient identified to benefit from a transplant protocol and who meets the inclusion/exclusion criteria above. The medical team will submit the consent and information leaflet to the patient likely to be included. This protocol will be presented and carried out, if accepted by the patient, as part of routine care. Each patient included must provide written informed consent.

The impact study provides for a longitudinal follow-up of the patients included, based on their transplant journey. A follow-up of 1 year from the inclusion of the patient to the announcement of the transplant will make it possible to assess in a relevant way the impact of the use of the platform, to identify medium-term profiles in relation to the events post-transplant (relapse, complications, etc.). The duration of the project, including inclusion and follow-up of patients, analysis and exploitation of results, is estimated at 24 months.

To date, the IT development of the platform is 85% complete; improvements still need to be made to optimize the tool, the generation and the collection of data. In addition, the enrichment of the platform continues with the integration of visually optimized illustrations and cooking recipes adapted to diets in the journey of the transplant patient.

Once the impact has been demonstrated and assuming positive results, the digital solution can be deployed on a national scale, in all French allograft centers. This deployment will be carried out in collaboration with the Francophone Society of Bone Marrow Transplantation and Cellular Therapy (SFGM-TC) and the Biomedicine Agency. It will be aimed at all transplant patients for a serious cancerous blood disease - leukemia, lymphoma, etc. - or not, adults and pediatrics, representing a population of approximately 2,000 people per year (see annual activity reports of the Biomedicine Agency). Given the growing number of patients going for transplant, the development and implementation of this support program will have a strong impact in the medico-social field. These arguments also support the long-term viability of this support program.