{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T11:28:13Z","timestamp":1783078093068,"version":"3.54.6"},"reference-count":20,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T00:00:00Z","timestamp":1783036800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"\n Background<\/jats:title>\n Hematopoietic stem cell transplantation (HSCT) is a potentially curative treatment for leukemia but is associated with high rates of complication-related morbidity, including infections, oral mucositis, graft-vs. -host disease (GVHD), and prolonged hospitalization. Structured nursing interventions may reduce these complications, yet comprehensive prospective evidence in adult leukemia patients remains limited.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n This study aimed to evaluate the effectiveness of a multifaceted structured nursing intervention program in reducing complication-related morbidity among leukemia patients undergoing autologous or allogeneic HSCT.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A prospective interventional study was conducted from June 2024 to June 2025 in a tertiary care bone marrow transplantation unit. A total of 106 consecutive adult leukemia patients (AML, ALL, CML, CLL) were enrolled. The structured nursing intervention included comprehensive pre-transplant education, strict infection prevention bundles, scheduled oral mucosal care, gastrointestinal and nutritional support, skin care protocols, GVHD surveillance (for allogeneic recipients), psychosocial support, and a daily structured assessment checklist. Complications were systematically monitored using standardized tools during hospitalization and up to 30 days post-transplant. Outcomes were compared before and after implementation of the intervention.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Following the intervention, significant reductions were observed in febrile neutropenia (from 64.2% to 37.7%, a reduction of 26.5 percentage points,\n p<\/jats:italic>\n = 0.002), oral mucositis Grade \u22652 (54.7%\u221228.3%,\n p<\/jats:italic>\n = 0.001), documented infections (49.1%\u221226.4%,\n p<\/jats:italic>\n = 0.004), acute GVHD (41.9%\u221224.2%,\n p<\/jats:italic>\n = 0.031), severe diarrhea (34.0%\u221217.0%,\n p<\/jats:italic>\n = 0.018), and skin complications (28.3%\u221213.2%,\n p<\/jats:italic>\n = 0.022). Hospital length of stay decreased from 28.6 \u00b1 6.4 to 23.2 \u00b1 5.1 days (\n p<\/jats:italic>\n = 0.001), ICU admissions reduced from 22.6% to 11.3% (\n p<\/jats:italic>\n = 0.041), and 30-day readmission rates fell from 18.9% to 8.5% (\n p<\/jats:italic>\n = 0.038). The proportion of patients with severe morbidity decreased from 30.2% to 15.1%.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Implementation of a structured nursing intervention program significantly reduced complication-related morbidity, shortened hospital stays, and improved clinical outcomes in leukemia patients undergoing HSCT. These findings support the routine integration of standardized, evidence-based nursing protocols in HSCT care.<\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fmed.2026.1847947","type":"journal-article","created":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T11:10:52Z","timestamp":1783077052000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Effectiveness of structured nursing interventions in reducing complication related morbidity in leukemia patients undergoing hematopoietic stem cell transplantation"],"prefix":"10.3389","volume":"13","author":[{"given":"Lu","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Rehabilitation Medicine, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine","place":["Hangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peipei","family":"He","sequence":"additional","affiliation":[{"name":"Department of Hematology, The First Affiliated Hospital of Soochow University, Suzhou","place":["Jiangsu Province, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yinghui","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Hematology, The First Affiliated Hospital of Soochow University, Suzhou","place":["Jiangsu Province, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qin","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Hematology, The First Affiliated Hospital of Soochow University, Suzhou","place":["Jiangsu Province, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanqiu","family":"Miao","sequence":"additional","affiliation":[{"name":"Department of Hematology, The First Affiliated Hospital of Soochow University, Suzhou","place":["Jiangsu Province, 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