Preparative Regimens and Modification of Regimen‐Related Toxicities

Bensinger, William I.; Spielberger, Ricardo

doi:10.1002/9780470987070.ch13

Cited by 5 publications

(6 citation statements)

References 185 publications

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“…It was seen in one-third of patients, and was usually mild-or-moderate, except for some III1 stomatitis in children who had received higher-dose levels of TREO (36-42 g/m 2 ). This is remarkable, as a significant proportion of these patients were given, in addition to TREO, other agents with substantial mucosal toxicity, like cyclophosphamide, VP-16 and melphalan 26 as well as 'short' MTX for GVHD prophylaxis. 22,27 The majority of patients were at risk of veno-occlusive disease.…”

Section: Discussionmentioning

confidence: 99%

Treosulfan-based preparative regimens for allo-HSCT in childhood hematological malignancies: a retrospective study on behalf of the EBMT pediatric diseases working party

Wachowiak

Sykora²,

Cornish

et al. 2011

Bone Marrow Transplant

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This retrospective analysis evaluated 51 children (0.7-17 years; median eight) with high-risk or advanced hematological malignancies, including 18 (35%) patients undergoing second/third hematopoietic SCT (allo-HSCT), not eligible for standard myeloablative regimens and transplanted from matched sibling (MSD) (n ¼ 24) or matched unrelated (MUD) (n ¼ 27) donors. Preparative regimens were based on treosulfan (TREO) i.v., a structural analog of BU, given at total dose of 30 g/m 2 (n ¼ 21) or 36-42 g/ m 2 (n ¼ 30) in combination with, fludarabine, cyclophosphamide, melphalan and/or VP-16 according to diagnosis, and risk factors. Deaths due to early regimenrelated toxicity (RRT) did not occur. Nonrelapse mortality was 8% at 1 year and 16% after 4 years. Myeloid engraftment was achieved in 94%, complete donor chimerism in 90% of patients. A 4-year incidence of relapse was 24%, and was significantly lower after MUD-HSCT (8%) than after MSD-HSCT (39%), but similar in children undergoing first (28%) or second/third HSCT (17%). A 4-year disease-free survival was 61%, but it was significantly better in myeloid (73%), than in lymphoid malignancies (41%). Thus, children with high-risk and advanced hematological malignancies and high-risk of life-threatening RRT can be transplanted effectively and safely using TREO-based regimens. Particularly favorable results were achieved in myeloid malignancies and in children undergoing second HSCT.

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Section: Discussionmentioning

confidence: 99%

Treosulfan-based preparative regimens for allo-HSCT in childhood hematological malignancies: a retrospective study on behalf of the EBMT pediatric diseases working party

Wachowiak

Sykora²,

Cornish

et al. 2011

Bone Marrow Transplant

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“…136 Gastrointestinal tract or liver complications are almost always the dose-limiting toxicities for these therapies. 137 The disruption of the mucosal barrier contributes to the development of infections during the period of ablation-induced neutropenia that may last as long as 6 weeks. As a result of mucositis, intense diarrhea, and systemic effects of chemotherapy, patients experience a prolonged period of minimal oral intake.…”

Section: B Nutrition Support Therapy In Hematopoietic Cell Transplanmentioning

confidence: 99%

“…They may also experience difficulty eating for a variety of reasons dependent on organ involvement and frequently require modified diets, oral supplements, or NST to prevent malnutrition. 137,139 Significantly higher mortality occurs in underweight patients undergoing HCT, even among those with only mild deficits. 135,140 Obesity also appears to have a negative influence on outcome.…”

Section: B Nutrition Support Therapy In Hematopoietic Cell Transplanmentioning

confidence: 99%

A.S.P.E.N. Clinical Guidelines: Nutrition Support Therapy During Adult Anticancer Treatment and in Hematopoietic Cell Transplantation

August

Huhmann

2009

J Parenter Enteral Nutr

420

264

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“…The decline in febrile episodes may be related to the optimization of anti‐allergic medications and interruption or reduction in the ATG infusion rate when necessary. We believe that fever episodes observed on the last days of conditioning may be related to the beginning of the neutropenic phase of transplant and to the higher incidence of infections (Bensinger & Spielberger, 2007). The conditioning regimen also promotes cell lysis, endothelial damage and systemic inflammation, which may also contribute to increased body temperature at this stage of AHSCT.…”

Section: Discussionmentioning

confidence: 99%

Nursing interventions in autologous stem cell transplantation for autoimmune diseases

Nilsen

Santos

Leopoldo

et al. 2020

Journal of Advanced Nursing

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Aims To identify clinical symptoms and nursing interventions for stem cell therapy in autoimmune diseases. Design This is a retrospective, cross‐sectional study. Methods This study was undertaken with patients diagnosed with type 1 diabetes or multiple sclerosis, undergoing autologous haematopoietic stem cell transplantation from January 2004 ‐ December 2018. Data were registered in a questionnaire, taken during the conditioning regimen comprising cyclophosphamide and rabbit anti‐thymocyte globulin. Descriptive statistics and Fisher's exact test were used for data analysis. Results There were 68 and 23 patients in the multiple sclerosis and type 1 diabetes groups respectively. Skin rash, nausea, vomiting and fever were more frequent and diverse in the type 1 diabetes group. Steroids were used as prophylaxis for anti‐thymocyte globulin‐associated allergic reactions in 97% of multiple sclerosis patients. Most of the identified symptoms and nursing interventions were more associated with one or other disease group (p < .05) and were more frequent in the type 1 diabetes group. Conclusion Patients with autoimmune diseases who underwent stem cell therapy present differences in their repertoire of adverse events and require disease‐specific nursing actions. Impact Our results may enable nurses to establish transplant and disease‐specific guidelines to improve prevention and management of adverse events and therefore optimize patient care and therapeutic success.

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Preparative Regimens and Modification of Regimen‐Related Toxicities

Cited by 5 publications

References 185 publications

Treosulfan-based preparative regimens for allo-HSCT in childhood hematological malignancies: a retrospective study on behalf of the EBMT pediatric diseases working party

Treosulfan-based preparative regimens for allo-HSCT in childhood hematological malignancies: a retrospective study on behalf of the EBMT pediatric diseases working party

A.S.P.E.N. Clinical Guidelines: Nutrition Support Therapy During Adult Anticancer Treatment and in Hematopoietic Cell Transplantation

Nursing interventions in autologous stem cell transplantation for autoimmune diseases

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