Recommended screening and preventive practices for long-term survivors after hematopoietic cell transplantation

Advances in hematopoietic cell transplantation (HCT) technology and supportive care techniques have led to improvements in long-term survival after HCT. Emerging indications for transplantation, introduction of newer graft sources (e.g. umbilical cord blood) and transplantation of older patients using less intense conditioning regimens have also contributed to an increase in the number of HCT survivors. These survivors are at risk for developing late complications secondary to pre-, periand post-transplant exposures and risk-factors. Guidelines for screening and preventive practices for HCT survivors were published in 2006. An international group of transplant experts was convened in 2011 to review contemporary literature and update the recommendations while considering the changing practice of transplantation and international applicability of these guidelines. This review provides the updated recommendations for screening and preventive practices for pediatric and adult survivors of autologous and allogeneic HCT.

Os avanços na tecnologia do transplante de células hematopoéticas (TCH) e do tratamento de suporte levaram a melhoria na sobrevida a longo prazo após os TCH. Indicações emergentes de transplante, introdução de novas fontes de células (p.ex. sangue de cordão umbilical) e transplante de pacientes mais velhos utilizando regimes de condicionamento menos intensos também contribuíram para o aumento no número de sobreviventes após TCH. Estes sobreviventes estão sob risco de desenvolver complicações tardias devido a exposições e fatores de risco pré, peri e pós-transplante. Práticas recomendadas para a triagem e a prevenção de complicações em sobreviventes de TCH foram publicadas em 2006. Um grupo internacional de especialistas foi formado em 2011 para rever a literatura contemporânea e atualizar as recomendações, considerando as mudanças nas práticas de transplante e a aplicabilidade internacional destas recomendações. Esta revisão fornece as recomendações atualizadas para o diagnóstico precoce e práticas para prevenção de complicações aos sobreviventes de TCH autólogo e alogênico, adultos e crianças.

The review of the patterns of presentation and various prognostic factors in male breast cancer patients.

This study was aimed to analyze the patterns of presentation, various prognostic factors and therapeutic modalities for the management of breast cancer in male patients. Thirty cases of male breast cancer were treated with radiotherapy at our department between 1983 and 1997. All the patients were treated with radiotherapy besides surgery (26) and chemotherapy (12). Radical mastectomy was performed in 18 patients, while 6 patients were treated with modified radical mastectomy and 2 patients with simple mastectomy. The post operative radiotherapy was applied at the dose of 50 Gy in 25 fractions over a period of five weeks. The chemotherapy was administered in an adjuvant setting. All the patients were received hormonal therapy. Four patients were lost to follow up. The follow up period ranged from 10-92 months with a median of 38 months. The disease-free survival at 2 and 5 years were 87.7% and 54.67%, respectively. One patient recurred locally, whereas 5 patients had distant metastasis. The age, lymph node status at presentation and presence of distant metastasis were the important prognostic factors. At present, the trend is to treat male breast cancer patients like those of females stage per stage. More randomized studies are required for optimizing therapeutic approach.