The Evaluation and Counseling of Candidates for Hematopoietic Cell Transplantation

Blume, Karl G.; Amylon, Michael D.

doi:10.1002/9780470987070.ch33

Cited by 8 publications

(8 citation statements)

References 70 publications

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“…Information on conditioning therapy, acute and chronic GVHD and late sideeffects on fertility was not provided and might have further influenced the patient's thoughts. 18 The survey also does not provide us with any insights into the motivations behind patient's decisions or recommendations of the health care providers.…”

Section: Discussionmentioning

confidence: 99%

Allogeneic stem cell transplantation for sickle cell disease. A study of patients' decisions

Besien

Koshy

Anderson-Shaw

et al. 2001

Bone Marrow Transplant

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Summary:Allogeneic stem cell transplantation is increasingly considered as a curative though risky treatment option for adults with sickle cell disease. Little is known about attitudes of adult patients and their health care providers regarding the risks and benefits of transplantation. A survey of 100 patients and their health care providers was undertaken. Assessment of risk was by a reference gamble paradigm. Comparison was made of the characteristics of those accepting substantial risk vs those not accepting risk, as well as assessment of agreement on risks recommended by health care providers and accepted by patients. Sixty-three of 100 patients were willing to accept some short-term risk of mortality in exchange for the certainty of cure. Fifteen patients were willing to accept more than 35% mortality risk. No differences in patient or disease-related variables were identified between those accepting risk and those not accepting risk. There was no agreement between the recommendations of health care providers and the risk accepted by patients. A substantial proportion of adults with sickle cell disease are interested in curative treatment, at the expense of considerable risk. The decision to accept risk is influenced by individual patient values that cannot be easily quantified and that do not correlate with the assessment of the health care provider. Given the substantial interest in curative therapy, education about and consultation for allogeneic stem cell transplantation in sickle cell patients should be encouraged. Bone Marrow Transplantation (2001) 28, 545-549. Keywords: sickle cell disease; stem cell transplantation; risk; survey Sickle cell disease is a common congenital disorder with major implications for the health and longevity of affected 1 Several mature studies of allogeneic transplantation in children with sickle cell disease indicate a cure rate of 80%, a transplant-related mortality of less than 10% and a risk for serious complications (ie graft failure, grade III-IV acute GVHD and extensive chronic GVHD) of less than 10%.2,3 In one study, survival and cure rates were even better in children with early stage sickle cell disease.2 In adults, sickle cell disease causes considerably more morbidity and mortality than in children, and no satisfactory medical treatment exists.

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Section: Discussionmentioning

confidence: 99%

Allogeneic stem cell transplantation for sickle cell disease. A study of patients' decisions

Besien

Koshy

Anderson-Shaw

et al. 2001

Bone Marrow Transplant

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“…7,18,25 However, a very limited range of variables has been investigated especially compared with those identified as potentially relevant when considering functioning of adult patients post-HSCT. 63 In the same article, Blume and Amylon 63 emphasize the importance of assessing the child's school and social …”

Section: Discussionmentioning

confidence: 99%

Health-related quality of life in survivors of BMT for paediatric malignancy: a systematic review of the literature

Clarke

Eiser

Skinner

2008

Bone Marrow Transplant

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“…The study investigators registered patient demographics and clinical characteristics, including severe lung and heart abnormalities and every cause of death which occurred after AuHCT. As almost all patients were adolescents or young adults at the end of the study, they were evaluated by means of either the Lansky (<16 yr old) or Karnofsky performance score (>16 yr) (6).…”

Section: Methodsmentioning

confidence: 99%

Cardiac and pulmonary late effects do not negatively influence performance status and non‐relapse mortality of children surviving five yr after autologous hematopoietic cell transplantation: Report from the EBMT Paediatric Diseases and Late Effects Working Parties

Uderzo¹,

Pillon

Tridello

et al. 2009

Pediatric Transplantation

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The current prospective study dealt with clinical outcome associated with pulmonary and cardiac late effects of AuHCT in children with malignancies. We prospectively evaluated 58 children, utilizing pulmonary function tests and cardiac shortening fraction, performed in pre-AuHCT phase and then annually. The overall five-yr survival was 68%. The five-yr cumulative incidence of lung and cardiac function impairment in survivors was 21% in both cases. None of the patients presented with restrictive or obstructive pulmonary pathology at the last follow-up and performance status for all survivors, ranged from 90% to 100%. The cumulative incidence of non-relapse mortality was 12.6% (range 6.3-25.3%), whereas relapse mortality was 19.7% (range 11.6-33.5). In conclusion, our study shows no significant deterioration in post-AuHCT pulmonary and cardiac function and in particular, no negative impact of lung and heart late effects on performance status and non-relapse mortality.

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The Evaluation and Counseling of Candidates for Hematopoietic Cell Transplantation

Cited by 8 publications

References 70 publications

Allogeneic stem cell transplantation for sickle cell disease. A study of patients' decisions

Allogeneic stem cell transplantation for sickle cell disease. A study of patients' decisions

Health-related quality of life in survivors of BMT for paediatric malignancy: a systematic review of the literature

Cardiac and pulmonary late effects do not negatively influence performance status and non‐relapse mortality of children surviving five yr after autologous hematopoietic cell transplantation: Report from the EBMT Paediatric Diseases and Late Effects Working Parties

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