ABSTRACT
BACKGROUND:Reduced-intensity conditioning alogeneic hematopoietic stem cel transplantation (RIC-alo-HSCT) is proved being one of the effective methods to cure hematologic malignancies recently, which has been used more and more in patients with matched sibling or matched unrelated donor year by year. It is more suitable for elderly patients or younger patients combined with any organ dysfunction or complications. However, matched sibling and matched unrelated donors are not easy to be obtained for RIC-alo-HSCT. While HLA-haploidentical donor can be quickly found in family members for the patients who need receiving RIC-alo-HSCT. Fewer papers for reduced-intensity conditioning haploidentical hematopoietic stem cel transplantation (RIC-haplo-HSCT) have been reported in the world, and none in China, so the review for RIC-haplo-HSCT is necessary. OBJECTIVE:To reveiw the application of RIC-haplo-HSCT and its prospect. METHODS:Using “nonmyeloablative conditioning, reduced intensity conditioning, HLA-haploidentical, hematopoietic stem cel transplantation” as key words, we retrieved Wanfang, CNKI and PubMed databases, and foreign language search platform (1997-2014) by computer for literatures about RIC-haplo-HSCT. According to the inclusion and exclusion criteria, 25 articles in English were selected for our review ultimately. RESULTS AND CONCLUSION: This review shows that RIC-alo-HSCT with matched sibling and matched unrelated donor is widely used and has a better result increasingly. RIC-haplo-HSCT is carried out relatively late and less, and its engraftment, infection, transplant-related mortality, graft-versus-host disease, long-term disease-free survival and overal survival in the early period is a bit weak, but overal the situation has been recently improved significantly. Currently RIC-haplo-HSCT is feasible, especialy for patients lack of matched sibling donor and matched unrelate donor, and HLA haploidentical donor becomes the most potential source of hematopoietic stem cels. RIC-haplo-HSCT retains strong graft-versus-leukemia effect, and is easy to look for donor, as wel as there are sufficient cels for subsequent treatments such as donor lymphocyte infusion, which through a graft-versus-leukemia effect can eliminate the patient’s malignant cels, especialy for elderly patients and younger patients combined with any organ dysfunction or complications. However, due to the relative short time to carry out RIC-haplo-HSCT, how to choice optimal RIC regimen and optimal opportunity and how to reduce transplant-related mortality, graft-versus-host disease and relapse rate require further in-depth studies.
ABSTRACT
BACKGROUND:Hematopoietic stem cel transplantation is the main treatment for leukemia, lymphoma and other blood diseases, but there are various negative factors during the transplantation process that have important implications for the success of hematopoietic stem cel transplantation. OBJECTIVE:To analyze the psychological characteristics of patients undergoing hematopoietic stem cel transplantation and to focus on the implementation effects of psychological intervention. METHODS: From January 2012 to December 2013, totaly 92 patients were admitted at the Hematopoietic Stem Cel Transplantation Center, the majority of whom had received autologous peripheral blood stem cel transplantation. Fifty-five of 92 patients were subjected to alogeneic stem cel transplantation, including 48 cases of relative sources and 7 of unrelated peripheral blood stem cel transplantation. Bone marrow suppression and composite grafting were carried out in some patients. According to the characteristics of negative factors at the different stages of stem cel transplantation, targeted interventional measures were performed, including psychological supports, prevention, observation and treatment of complications, and whole environmental protection programs. RESULTS AND CONCLUSION:Hematopoietic stem cel transplantation was successfuly implemented in al patients who had good compliance behaviors (medication, diet, and daily schedule), and had no the folowing adverse events: psychological stress, out of emotional control, destroying objects. No significant difference was found in the incidence of complications, the incidence of adverse events, and patient satisfaction rate during 2012-2013 (P > 0.05). Because the hematopoietic stem cel transplantation has strong specificity, patients need to strictly comply with the treatment path, stay long in laminar flow wards longer, and bear a greater psychological and physiological burden, whose behaviors are severely restricted. We should strictly implement aseptic standards, strengthen ward management and provide good guidance and support for patients, so as to reduce post-transplantation complications and ensure the successful completion of hematopoietic stem cel transplantation.