• 종양간호연구
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• 제9권1호
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• pp.7-14
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• 2009

Purpose: This study was to analyze the level of quality of life and sexual function of Hematopoietic Stem Cell Transplantation (HSCT) recipients. Method: Participants included 38 recipients of HSCT, attending hospital outpatient department. Data were collected using the quality of life scale and the sexual function scale. Data were analyzed using Descriptive statistics, t-test, ANOVA, Sheff$\acute{e}$ test, and Kruskal-Wallis test. Results: The high score of quality of life was found in the participants with the 30s age (p=0.030), being employed (p=0.001), not having admission history after HSCT (p=0.012), and not having medication (p=0.017). The sexual function was significantly influenced by employment status (p=0.001) and irradiation therapy (p=0.043). There was a significant correlation between the quality of life and the sexual function (r=0.45, p=0.004). Conclusion: The sexual function have influence on the quality of life so that it is required to develop nursing interventions for sexual function to improve the quality of life of HSCT recipients.

• Clinical and Experimental Pediatrics
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• 제54권3호
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• pp.106-110
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• 2011

In pediatric patients with acute lymphoblastic leukemia (ALL), the Philadelphia chromosome translocation is uncommon, with a frequency of less than 5%. However, it is classified as a high or very high risk, and only 20-30% of Philadelphia chromosome-positive (Ph+) children with ALL are cured with chemotherapy alone. Allogeneic hematopoietic stem cell transplantation from a closely matched donor cures 60% of patients in first complete remission. Recent data suggest that chemotherapy plus tyrosine kinase inhibitors (TKIs) may be the initial treatment of choice for Ph+ ALL in children. However, longer observation is required to determine whether long-term outcome with intensive imatinib and chemotherapy is indeed equivalent to that with allogeneic related or alternative donor hematopoietic stem cell transplantation (HSCT). Reports on the use of second-generation TKIs in children with Ph+ ALL are limited. A few case reports have indicated the feasibility and clinical benefit of using dasatinib as salvage therapy enabling HSCT. However, more extensive data from clinical trials are needed to determine whether the administration of second-generation TKIs in children is comparable to that in adults. Because Ph+ ALL is rare in children, the question of whether HSCT could be a dispensable part of their therapy may not be answered for some time. An international multicenter study is needed to answer the question of whether imatinib plus chemotherapy could replace sibling allogeneic HSCT in children with Ph+ ALL.

• Clinical and Experimental Pediatrics
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• 제56권8호
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• pp.343-350
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• 2013

Purpose: Despite the established role of imatinib (IM) in chronic myelogenous leukemia (CML) in adults, there are few reports on its efficacy in children. In this study, we compared the outcomes of children with CML before and after the advent of IM-based treatment. Methods: The study cohort consisted of 52 patients treated for CML at the Department of Pediatrics, The Catholic University of Korea from January 1995 to October 2010. Patients were divided and analyzed according to the preImatinib group (pre-IMG) and imatinib group (IMG). Results: Median age at diagnosis for the overall cohort (pre-IMG, n=27; IMG, n=25) was 9 years, with a median follow-up duration of survivors of 84 months. Except for 5 patients in the IMG, all were diagnosed in chronic phase (CP). The overall survival (OS) of patients diagnosed in CP was 45.7% and 89.7% for pre-IMG and IMG, respectively (P=0.025). The OS of hematopoietic stem cell transplantation (HSCT) recipients in the 2 groups was similar, but the OS of patients diagnosed in CP who did not receive HSCT was superior in IMG (91.7% vs. 16.7%, P=0.014). Of the 12 patients in IMG who remained on IM without HSCT, 2 showed disease progression, compared to 11 of 12 in pre-IMG. No difference was observed in the progression free survival (PFS) of matched donor HSCT recipients and IM-based treatment recipients. Conclusion: Similar PFS of patients treated with IM and those who received matched donor HSCT underscore the potential of IM as effective first-line treatment in childhood CML.

• 한국임상약학회지
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• 제20권3호
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• pp.193-199
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• 2010

Tacrolimus, an immunosuppressant prescribed against graft-versus-host disease (GVHD) in patients with allogeneichematopoietic stem cell transplantation (HSCT), is affected to change its pharmacokinetic properties by various factors. For this reason, it is needed a close monitoring to adjust dosage amount in order to optimize the blood concentration of tacrolimus is located within the effective range. According to our in-house study, 62% of HSCT-patients were needed dosage-adjustment and it is necessary to optimize the current immunosuppressive regimen in clinical settings. A retrospective study was designed to evaluate the dosing regimen (converting ratio of IV:PO=1:4) of tacrolimus in HSCT patients (n=62). After collecting data from patient's profile and medical record, pharmacokinetic parameters were calculate and compared between the estimated and the actual values in the selected subjects (n=58). It was found that the bioavailabilty (BA) of oral tacrolimus was 40.5% very much different from that is known as 25%. It implies that the current protocol has a potent risk causes dose-related toxicities to the patients. Furthermore, analyses among factors demonstrated that there was no statistical significance between BA of tacrolimus and the variable factors. In the clinical perspectives, the current converting ratio of tacrolimus in patients with HSCT to be re-considered and an appropriate and optimal alternative regimen should be adopted to prevent GVHD and to increase the quality of life of patients.

• Asian Pacific Journal of Cancer Prevention
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• 제17권9호
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• pp.4477-4481
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• 2016

Purpose: To compare the relative merits of imatinib and allogeneic hematopoietic stem cell transplantation (allo-HSCT) for chronic myelogenous leukemia (CML). Materials and Methods: This cohort study was designed to compare the outcomes of imatinib (n=292) versus allo-HSCT (n=141) for CML, the clinical data of these patients being retrospectively analyzed so as to compare the event free survival (EFS) and overall survival (OS) between these two groups with patients in the chronic phase (CP) and advanced phases, including accelerate (AP) and blast phases (BP). Results: (1) Patients treated with imatinib (278 in the CP) demonstrated superior EFS, OS, 5-year EFS and 5-year OS rates of 88.5% versus 70.0% (P<0.05), 93.2% versus 80.0% (P<0.05), 84% versus 75.0% (P<0.05) and 92% versus 79.0% (P<0.05), respectively, to those treated with allo-HSCT (120 patients in the CP). (2) Both treatments resulted in similar survival, with EFS and OS rates of 42.9% versus 47.6% (P>0.05), 42.9% versus 57.1% (P> 0.05), respectively, for imatinib (14 patients in the AP and BP) and allo-HSCT (21 patients in the AP and BP). Conclusions: Imatinib confers significant survival advantage (EFS and OS) for CML patients with CP compared with allo-HSCT treatment. However, the outcomes are equally good with both treatments in AP and BP patients.

• 성인간호학회지
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• 제28권1호
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• pp.30-42
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• 2016

Purpose: This study aimed to examine the relationships among social support(family support, medical team support), hope, anxiety, and depression in patients with hematologic cancers before they received hematopoietic stem cell transplantation (HSCT) to obtain baseline data for developing a nursing intervention. Methods: The participants were 70 adult patients expecting to receive HSCT from 5 university hospitals in Seoul, Gyeonggi-do, and Jeollanam-do regions. A cross-sectional survey was done using standardized instruments for social support (Tae's Family Support Scale and Professional Medical Support Scale), hope (Kim & Lee Hope Scale), anxiety and depression (Hospital Anxiety and Depression Scale). The data were analyzed by SPSS/WIN 19.0 program using frequency, percentage, item mean and standard deviation, t-test, ANOVA, and Pearson's correlation coefficient. Results: Hope was significantly correlated with social support (r=.40, p=.001), anxiety (r=-.40, p<.001) and depression (r=-.58, p<.001). Anxiety was correlated with depression (r=.54, p<.001). Conclusion: The findings of this study show greater social support for patients who expect to receive HSCT is significantly correlated to a higher level of hope, as well as low levels of anxiety and depression. In nursing practice, clinical nurses may develop a nursing intervention to reinforce social support and hope, as well as reduce anxiety and depression for patients preparing for HSCT.

• 종양간호연구
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• 제10권2호
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• pp.119-128
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• 2010

Purpose: This study aimed to evaluate the effectiveness of continuous nutritional education and oral mucositis management on the nutritive status of patients who received hematopoietic stem cell transplantation (HSCT). Methods: After randomly allotting 72 patients who received HSCT to either an experimental group or a control group, intensive and continuous care for preventing malnutrition was conducted in the experimental group while usual routine care was conducted in the control group. The changes of the body scale, blood chemistry profile, oral intake calories, nausea and vomitus, and oral stomatitis scores were measured at three points during their hospitalization using a oral assessment guide and nutrition analysis program: admission, HSCT, and discharge day. The differences between the scores of two groups were analyzed by repeated measures analysis of covariance. Results: The number of total lymphocytes was significantly improved in the experimental group after transplantation (p<.001). Nausea and vomiting score was significantly decreased in the experimental group during the conditioning regimen (p<.001). Conclusion: It was found that continuous nutritional education and oral mucositis control is an effective intervention by improving immune condition. Further investigations concerning direct examination of oral intake with controlling the effect of the chemotherapy are needed to ultimately discern the impact of varying oral nutrition patterns during HSCT.

• Annals of Laboratory Medicine
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• 제38권6호
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• pp.591-598
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• 2018

Background: Forkhead box P3 (FOXP3) is an important marker of regulatory T cells. FOXP3 polymorphisms are associated with autoimmune diseases, cancers, and allograft outcomes. We examined whether single nucleotide polymorphisms (SNPs) at the FOXP3 locus are associated with clinical outcomes after allogenic hematopoietic stem cell transplantation (HSCT). Methods: Five FOXP3 SNPs (rs5902434, rs3761549, rs3761548, rs2232365, and rs2280883) were analyzed by PCR-sequencing of 172 DNA samples from allogenic HSCT patients. We examined the relationship between each SNP and the occurrence of graft-versus-host disease (GVHD), post-HSCT infection, relapse, and patient survival. Results: Patients with acute GVHD (grades II-IV) showed higher frequencies of the rs3761549 T/T genotype, rs5902434 ATT/ATT genotype, and rs2232365 G/G genotype than did patients without acute GVHD (P =0.017, odds ratio [OR]=5.3; P =0.031, OR=2.4; and P =0.023, OR=2.6, respectively). Multivariate analysis showed that the TT genotype of rs3761549 was an independent risk factor for occurrence of acute GVHD (P =0.032, hazard ratio=5.6). In contrast, the genotype frequencies of rs3761549 T/T, rs5902434 ATT/ATT, and rs2232365 G/G were lower in patients with post-HSCT infection than in patients without infection (P =0.026, P =0.046, and P =0.031, respectively). Conclusions: rs3761549, rs5902434, and rs2232365 are associated with an increased risk of acute GVHD and decreased risk of post-HSCT infection.

• Clinical and Experimental Pediatrics
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• 제50권7호
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• pp.613-621
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• 2007

Hematopoietic stem cell transplantation (HSCT) has expanded and evolved substantially in the last decades to treat various malignant and nonmalignant diseases. However, the conditioning regimen can lead to transplantation related death by major organ dysfunction, severe infection and bleeding. In the allogeneic setting, graft versus host disease may also develop, making post-transplant management complex. To overcome these problems, new stem cell sources, stem cell mobilizing agents and new skills, nonmyeloablative stem cell transplantation including reduced intensity stem cell transplantation has been introduced in clinical practice, but problems remained so far. Recipients of stem cell transplant may be severely immunocompromised for many months after transplantation. Furthermore, long-term complications (endocrine, metabolic, relapse, second malignancies, etc) can develop. Pediatrician is open called on to participate in the evaluation and consideration of patients for possible transplant and long-term follow-up of HSCT patients. This review is intended as a basic overview of HSCT relevant to general pediatrician.

• Clinical and Experimental Pediatrics
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• 제49권11호
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• pp.1211-1215
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• 2006

목 적 : 본 연구는 소아 동종 조혈모세포이식 후에 갑상선 기능의 단기간 변화와 갑상선기능이상의 빈도와 위험인자를 분석하고자 하였다. 방 법 : 2004년 1월부터 2006년 2월까지 가톨릭대학교 성모병원 소아과, 조혈모세포이식센터에서 동종 조혈모세포이식을 시행한 80명의 환자를 대상으로 연구를 하였다. 조혈모세포이식 전과 이식 후 1개월, 6개월, 12개월에 환자들의 혈청에서 TSH, T4, T3를 측정하였다. 결 과 : 조혈모세포이식을 하고 1개월 후의 갑상선 기능은 통계적으로 유의한 감소를 보이고 있었다(P<0.001). 1개월 후 갑상선 기능이상의 빈도는 80명중 43명(54%)에서 보였으며 이들 중 31명(39%)은 ETS를 보이고 있었다. 이식 후 일년 이내 갑상선 기능은 대부분 정상으로 회복되었다. 단변량 분석에 의하면 악성 질환인 경우(P=0.04)와 2도 이상의 급성 이식편대 숙주병(P=0.01)이 ETS의 위험인자였으나(P=0.04), 다변량 분석에 의하면 ETS 발생에 독립적인 위험인자는 찾을 수 없었다(P=0.19, 0.06). 결 론 : 조혈모세포이식 후 갑상선 기능이상은 초기에 높은 빈도로 발생함을 알 수 있었다. 따라서 이식 후에는 갑상선 기능의 지속적인 추적검사가 필요하다.