Clinical and epidemiological profile of children and adolescents submitted to the hematopoietic cell transplantation

Abstract

The Hematopoietic stem cell transplantation (HSCT) is used in children as a definitive treatment for various oncological, immune deficiencies, hemoglobinopathy, and malignancies diseases that involve the hematological system, congenital metabolism disorders, among others. To characterize the clinical and epidemiological profile of children and adolescents submitted to HSCT at a referral service in the state of Rio Grande do Norte. This is a quantitative, retrospective, observational, descriptive and analytical quantitative approach approaching the medical records of children and adolescents submitted to HSCT in a referral hospital service for this type of transplantation in the state of Rio Grande do Sul North (RN). The final sample consisted of 35 records patients aged between 2 and 18 years old who underwent HSCT from February 2008 to December 2015 and who presented the data necessary for the study. The records analyzed showed a little majority of male patients (51.42%) and 60.00% of these men were students and 71.42% lived in the state of the Rio Grande do Norte. According to the clinical characteristics, 34.3% of the patients had Acute Lymphoblastic Leukemia and 25.71% had Acute Myeloid Leukemia as the main diagnosis. Gastrointestinal toxicities were the most frequent (97.1%) and all patients received antineoplastic/chemotherapeutic and antiemetic treatment. The allogeneic HSCT was the most frequently performed (57.14%) and the most used source of Hematopoietic progenitor cells (HPC) was the peripheral blood (54.29%) and 5.71% of these patients developed the Graft versus Host Disease (GVHD), of which one was affected by acute GVHD and another by chronic GVHD. Septsis was the most frequent cause of death (60%). The profile of the clinical variables presented by the children and adolescents of this study shows that the most prevalent diagnosis was ALL, the most frequent toxicities were gastrointestinal, cardiac, respiratory and hematological, the most common HSCT was allogeneic peripheral blood and the greatest cause of mortality was sepsis. These data are similar to studies conducted in North America, Europe and Asia.

Elements for assistance to patients with hematological malignancies to propose care lines: a scoping review

“…In this regard, early diagnosis increases success in treatment and chances of cure. Nevertheless, in pediatric leukemia ( 30 - 31 ) , where primary prevention is not possible, related to modifiable factors ( 32 ) , often recommended to adults, such as smoking, alcoholism, sedentary lifestyle and other lifestyle habits, the importance of identifying the various technologies developed for the investigation of the disease is emphasized ( 33 ) .…”

Elementos para assistência a pacientes com neoplasias hematológicas para propor linhas de cuidado: scoping review

“…Nesse sentido, o diagnóstico precoce aumenta o sucesso no tratamento e as chances de cura. Não obstante, nas leucemias pediátricas (30)(31) , em que não é possível a prevenção primária, relacionada a fatores modificáveis (32) , frequentemente recomendada aos adultos, como tabagismo, etilismo, sedentarismo e outros hábitos de vida, ressalta-se a importância da identificação das diversas tecnológicas desenvolvidas para a investigação da doença (33) .…”

Self-care guidelines for patients in the post-hematopoietic stem cell transplantation period: a scoping review

“…Given the above, it is understood the importance of safe care at all stages of HCT, especially in the post-transplant period, when the patient resumes their routine outside the hospital environment and complications may arise that affect various organs and systems, in addition to the increased risk of infections due to the new hematopoietic and immune system still in formation ( 10 ) .…”