自体造血干细胞移植患者术前护理准备

对自体造血干细胞移植患者术前护理准备总结如下。 1临床资料 1．1一般资料本组5例均为男性，年龄5～45（平均22．5）岁。其中急性淋巴细胞性白血病2例，非霍奇金淋巴瘤2例，多发性骨髓瘤1例。     

自体造血干细胞移植治疗多发性骨髓瘤

多发性骨髓瘤是浆细胞恶性增生性疾病，化疗能取得一定疗效，但完全缓解率低，维持时间短。目前，造血干细胞移植治疗已经成为重要的手段之一，并且取得了很大的进展。     

自体造血干细胞移植患者的护理

目的:探讨自体造血干细胞移植患者的护理方法。方法:通过对21例自体造血干细胞移植患者的护理过程的回顾性分析,总结护理方法。结果:通过有效的护理指导与帮助,21例自体造血干细胞移植患者安全度过移植极期,无1例发生严重并发症。结论:对自体造血干细胞移植患者加强全环境无菌保护,细致的观察、护理及适时的心理指导,对患者的顺利康复非常重要。     

临床护理路径在外周血造血干细胞移植病人中的应用

目的探讨临床护理路径在外周血造血干细胞移植病人中的应用。方法根据病人全身状况的评估,制订出符合病人自身特点的移植护理路径表;在病人准备接受移植前进行具体内容的讲解,移植工作开始后护理人员根据制订的护理路径表,由责任护士或当班护士按路径表进行护理。结果临床护理路径以严格的时间框架为指导,使各项护理工作落实到位,获得了极高的医师和病人满意度。结论临床护理路径的实施有效地减少了护理差错的发生,提高了护理质量;避免了医疗纠纷;改善了医护、护患关系,增强了医务人员的团队精神;缩短了平均住院日,增强了病人的自我护理意识。     

自体造血干细胞移植并发症及护理

总结自体造血干细胞移植29例患者发生的并发症的护理体会,护理重点是自体造血干细胞移植后并发症的预防和护理,饮食,心理的护理。29例患者均完成自体干细胞移植3例死于肿瘤复发,5例复发后继续治疗,其余病人生存情况在随访中。     

自体造血干细胞移植的输液监护

在自体造血干细胞移植中（自体骨髓移植及自体外周造血干细胞移植），化疗药物、骨髓回输、营养供给、血制品应用等治疗均有赖于静脉输入。因此作好输液监护，保证各药物有序、准时、足量输入体内是取得移植成功的重要条件，下面就此谈谈我们的体会。1临床资料本组病人12例，其中急性白血症9例．恶性淋巴瘤2例，晚期肺癌1例；年龄9岁～58岁；男性6例，女性6例；全部病人均采用锁骨下静脉置管的方法；回输液量最多为11550m［，平均7600ml。日所用药物最多为24种，平均19种。2护理体会2．1制订输液计划表在移植之初，特别是预处理阶段，液体数…     

预见性护理程序在自体造血干细胞移植中的应用

目的 探讨预见性护理程序在自体造血干细胞移植过程中的应用效果.方法 预见性护理程序组20例,与过去常规护理方法组24例为对照,在移植过程中,以预见性护理程序为导向,实施责任制护理.结果 预见性护理程序组采取先预防后治疗的原则,使移植过程中并发症的发生率显著低于常规护理组.结论 预见性护理程序使护理工作由被动变为主动,有计划,有目的,有秩序地为患者提供个体化的最佳护理服务,有效预防并发症的发生或减轻并发症的症状,使患者早日康复.     

预见性护理程序在自体造血干细胞移植中的应用

目的探讨预见性护理程序在自体造血干细胞移植过程中的应用效果。方法预见性护理程序组20例,与过去常规护理方法组24例为对照,在移植过程中,以预见性护理程序为导向,实施责任制护理。结果预见性护理程序组采取先预防后治疗的原则,使移植过程中并发症的发生率显著低于常规护理组。结论预见性护理程序使护理工作由被动变为主动,有计划,有目的,有秩序地为患者提供个体化的最佳护理服务,有效预防并发症的发生或减轻并发症的症状,使患者早日康复。     

自体造血干细胞移植治疗恶性淋巴瘤的近况

自体造血干细胞移植治疗恶性淋巴瘤的近况达万明恶性淋巴瘤（ＭＬ）是我国常见的恶性肿瘤，其发病率约３～４／１０６。近代化（放）疗的进展虽可使约６０％的霍奇金病（ＨＬ）和近３０％的非ＨＬ（ＮＨＬ）长期存活，但对复发或持续未达缓解的患者，特别对中、高度恶性Ｎ...     

适时护理推送模式在自体造血干细胞移植患者中的应用

目的观察适时护理推送模式在自体造血干细胞移植患者中的应用效果。方法选择适时护理推送模式实施前2018年1—10月我院行自体造血干细胞移植患者43例作为对照组,将实施后2018年11月至2019年8月于我院行自体造血干细胞移植患者43例为试验组,对照组接受自体造血干细胞移植术常规护理,试验组接受适时护理模式干预,对两组干预后的各观察指标进行比较。结果试验组患者焦虑抑郁自评分值、消化道并发症发生率显著低于对照组,护理满意度评定分值显著高于对照组,(P<0.05)。结论采用适时护理推送模式对自体造血干细胞移植患者实施干预,可明显改善患者心理困扰,降低并发症风险,提高护理满意度。     

大剂量化疗联合自体干细胞移植治疗鼻咽部T细胞淋巴瘤

目的 评价大剂量化疗联合自体干细胞移植治疗鼻咽部T细胞淋巴瘤的价值.方法 回顾性分析天津医科大学附属肿瘤医院1995年1月至2007年1月接受大剂量放化疗联合自体干细胞移植治疗的51例鼻咽部T细胞淋巴瘤患者.结果 在51例行自体干细胞移植的患者中,无移植相关性死亡;16例患者在移植后出现复发,其中2例经过抢救性化疗在复发后91和56个月仍然存活,余14例患者死于肿瘤进展.1年、3年及5年的总生存(OS)率分别为98.0%、84.0%及72.0%.1年、3年及5年的无进展生存(PFS)率分别为90.2%、78.4%及66.7%.单因素分析显示临床分期、B症状和IPI评分是影响鼻咽部T细胞淋巴瘤预后的相关因素(P值分别为0.041、0.036和0.031).结论 大剂量化疗联合自体干细胞移植治疗鼻咽部T细胞淋巴瘤可显著提高患者的治愈率并延长其生存时间.     

Hematopoietic stem cell transplantation in geriatric patients in Turkey

The incidence of most hematologic malignancies increases with age. Physicians increasingly refer older patients for hematopoietic stem cell transplantation (HSCT) due to more experience and improved supportive care in HSCT. This article discusses the available data regarding the feasibility, tolerability, toxicity, and effectiveness of autologous and allogeneic HSCT in older adults.     

临床路径护理模式对造血干细胞移植患者治疗态度及情绪状态的影响

目的：探讨临床路径护理模式对造血干细胞移植患者治疗态度及情绪状态的影响。方法选取2015年1至6月在我院接受造血干细胞移植治疗的患者80例,按照随机数字表法分观察组和对照组,每组各40例,其中观察组患者接受临床路径护理模式护理,对照组患者接受血液科常规护理。使用 Frank 量表评价患者护理前和护理2周后的治疗态度,使用 POMS 量表和 SCL-90量表评价患者护理前和护理2周后的情绪状态。结果两组患者护理2周后治疗态度评分明显提高(P<0.05),观察组患者治疗态度评分提高显著优于对照组患者(P<0.05);两组患者护理2周后疲劳、抑郁、愤怒、紧张、慌乱等评分均显著下降,精力和自我相关情绪评分上升(P<0.05),观察组患者评分显著优于对照组患者(P<0.05);两组患者护理2周后躯体化、强迫状态、人际关系、抑郁、焦虑、敌对、恐惧、偏执状况评分均显著下降(P 均<0.05),观察组患者评分显著优于对照组患者(P<0.05)。结论临床路径护理模式对造血干细胞移植患者治疗态度和情绪状态具有重要意义,能有效改善患者治疗态度和心理状态。     

An alternative test for determining autologous stem cell transplantation cell harvesting outcome: Comparison between predictive values of two tests

Daily CD34+ cells enumeration as a success indicator of stem cell pheresis procedure using flow cytometry is costly, lengthy, and labor-intensive. Thus, finding a simpler method to achieve the optimum time for harvesting the minimum required stem cells for transplantation could be helpful. The aim of this study was to evaluate the predictive value of reticulocytes fractions and their sensesivity and specificity in guiding CD34+ cell harvesting by G-CSF mobilization strategy. In this study, 49 candidates for autologous peripheral blood stem cell transplantation were enrolled. Before leukapheresis, the immature reticulocytes fraction (IRF) and CD34+ cell count were measured. Moreover, patients were evaluated for leukapheresis outcomes in two MNC and cMNC groups. Here we demonstrated that IRF, LFR, and MFR with the associated criterion of >17.3, ≤82.5, and >15.9, respectively, earned 100 % specificity and 47.2 %, 47.22 %, and 41.46 % sensitivity to predict the minimum required CD34+ cell count. Furthermore, IRF-V (Value) and MFR-V with the associated criterion of >0.77 and >0.55, respectively, earned 58.33 %, 66.67 % sensitivity and 84.62 %, 69.23 % of specificity, separately. As only MFR-V was able to predict the platelet engraftment (P-value = 0.014), none of the other above mentioned factors were not able to predict the neutrophil engraftment. Likewise, it was shown that patients who underwent MNC leukapheresis had a statistically significantly higher total WBC, harvested CD34⁺ cells, MNCs/ kg, and lower apheresis durations (P-values<0.05). Taken together, using IRF and its maturity stages seems to be a compelling predictor of minimal required CD34+ cells in autologous peripheral blood stem cell transplantation.     

Autologous stem cell transplantation and stem cell mobilization kinetics in elderly patients with B cell non-Hodgkin lymphoma

As known, the world population is aging and as the life span increases the number of advanced-age lymphomas also shows an upward trend. Autologous hematopoietic stem cell transplantation (HSCT) is the standard treatment modality in chemotherapy-sensitive relapsed or refractory aggressive lymphomas. Increased morbidity and mortality related to both the transplant itself and comorbid diseases can be observed in elderly lymphoma patients. Patients who are 65 years or older and underwent autologous HSCT with B-cell non-Hodgkin lymphoma were retrospectively included in our study. In terms of survival analysis, median follow-up was 34.5 months (8–159) while the overall survival (OS) was 58%. In the univariate analysis of prognostic data in OS, patients who were referred to transplantation with complete response had a statistically significant survival advantage (p = 0.043). In terms of the effect of pre-transplant conditioning regimens on survival, BEAM regimen yielded better results, though not statistically significant. Age, number of chemotherapy cycles received before mobilization and radiation therapy had no significant effect on the CD34 (+) cell count in the final product (p = 0.492, 0.746 and 0.078 respectively). In conclusion, autologous HSCT is a practicable treatment modality that provides survival advantage in suitable advanced-age patients with a diagnosis of B-cell non-Hodgkin lymphoma.     

Cutaneous Mycobacterium chelonae infection following autologous peripheral blood stem cell transplantation for POEMS syndrome

Although hematopoietic stem cell transplantation (HSCT) may increase the curability of refractory hematologic diseases, it requires complication management due to a long-term immunocompromised state. We experienced a case who received an autologous peripheral blood stem cell transplantation (Auto-PBSCT) for POEMS syndrome (polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes) and developed cutaneous Mycobacterium chelonae infection. It is clear that attention needs to be paid to prevent bacterial, fungal and viral infection after HSCT. It is also important to keep in mind that tuberculous and nontuberculous mycobacteria (NTM), in rare cases, lead to lethal complications.     

自体造血干细胞移植治疗难治性恶性淋巴瘤疗效观察

目的探讨自体外周血造血干细胞移植(APBSCT)治疗难治性恶性淋巴瘤的临床疗效。方法APBSCT治疗难治性恶性淋巴瘤46例,采用环磷酰胺 阿霉素 长春新硷 泼尼松(CHOP)方案化疗加粒细胞集落刺激因子(G-CSF)动员外周血造血干细胞。结果43例获造血重建,完全缓解(CR)26例,占56.52%,部分缓解(PR)17例,占36.95%,1例死于肝静脉闭塞,2例死于严重感染,移植相关死亡率6.52%。结论APBSCT治疗难治性恶性淋巴瘤具有较好疗效。     

深低温保存自体外周血干细胞移植的护理

目的 探讨-80℃深低温保存自体外周血干细胞移植的护理,以总结对此类患者的护理经验.方法 对18例血液病和重症自身免疫性疾病患者进行-80℃深低温保存自体外周血干细胞移植治疗,通过监测-80℃低温冰箱温度,对患者进行移植前心理护理,移植过程中加强全环境保护及密切观察病情变化.结果 18例患者安全保存自体外周血干细胞24～230d,患者均成功进行移植治疗并重建造血功能,无护理并发症发生.结论 干细胞的安全保存,移植前后患者心理护理,移植中全环境保护及密切观察病情变化是移植治疗成功的关键.     

Impact of autologous stem cell transplantation on survival outcomes in patients with peripheral T cell lymphoma

Data about the timing of autologous stem cell transplantation (ASCT) in peripheral T cell lymphoma (PTCL) are conflicting. We aimed to investigate the impact of the sequence of ASCT on the survival outcomes in patients with PTCL. Analyzes were performed retrospectively in a total of 81 patients, 16 of whom underwent upfront ASCT and 12 received salvage ASCT. In univariate analysis, upfront ASCT reduced the risk of progression and death by 77% (Hazard ratio (HR): 0.23, 95% confidence interval (CI): 0.09–0.60) (p = 0.003) and by 84% (HR: 0.16, 95% CI: 0.5–0.55) (p = 0.003), respectively. However, in multivariate analysis, only salvage ASCT predicted a more favorable progression-free and overall survival (HR: 0.17, 95% CI: 0.06–0.48, p = 0.001 and HR: 0.20, %95 GA: 0.06–0.62, p = 0.005, respectively). In conclusion, regardless of first-line therapy, patients have more favorable outcomes if they receive salvage ASCT. Upfront ASCT does not add clinically significant benefit to survival outcomes.