Prevention of Delirium After Bone Marrow Transplantation

• Incidence of delirium (Time to the development of delirium based on meeting criteria on the Delirium Rating Scale and/or Memorial Delirium Assessment Scale) [ Time Frame: From hospital admission until the date of first documented delirium, assessed up to 28 days post-transplant ] [ Designated as safety issue: No ]
  Monday, Wednesday, and Friday assessments will begin the day after transplant and include the Delirium Rating Scale-Revised-98 (DRS-98)and Memorial Delirium Assessment Scale (MDAS)
  
  

• Length and severity of delirium episodes [ Time Frame: From first documented episode of delirium until discharge from the hospital, assessed up to 28 days post-transplant ] [ Designated as safety issue: No ]
  Monday, Wednesday, and Friday assessments include the Delirium Rating Scale-Revised-98 (DRS-98)and Memorial Delirium Assessment Scale (MDAS); Patients will receive assessments beginning the day after transplant until day 28 post-transplant or discharge, whichever comes first
  
  
• Average dose of antipsychotic medications required to manage delirium [ Time Frame: From admission to hospital to discharge, an expected average of 28 days post-transplant ] [ Designated as safety issue: No ]
  
• Hospital length of stay [ Time Frame: From admission to hospital to discharge, an expected average of 28 days post-transplant ] [ Designated as safety issue: No ]
  
• Complications (falls, aspiration, infections, nutritional deficits) [ Time Frame: From admission to hospital to discharge, an expected average of 28 days post-transplant ] [ Designated as safety issue: No ]
  Available and pertinent laboratory data will be collected including serum electrolytes, serum BUN, serum creatinine, TSH, LFTs, CBC with differential, Alkaline phosphatase and urinalysis. These tests are performed as part of routine clinical care on patients undergoing HSCT.
  
  

This is a pilot, double blind randomized study conducted in patients scheduled to undergo bone marrow transplant at the Massachusetts General Hospital. The goal of this study is to look at the usefulness of bright light therapy in the prevention of delirium in a population at high risk for developing this condition.

Delirium can develop in up to half of the people that undergo bone marrow transplant. Symptoms include changes in level of alertness, confusion, and temporary problems with memory and attention. In severe cases, it can be accompanied by agitation, paranoia(overly suspicious), and hallucinations(seeing or hearing things that are not really there).

Bright light uses no medication and is often used to treat seasonal affective depression and multiple sleep disorders. The light boxes are portable and are placed in front of individuals for about 30 minutes every day.