Journal of the Korea Convergence Society (한국융합학회논문지)

Korea Convergence Society (한국융합학회)
권호 표지
DOI QR코드

DOI QR Code

A convergence study about Influences of hematopoietic stem cell transplantation on children growth

소아암 환아의 조혈모세포이식 후 성장에 관한 융합 연구

  • Lim, Su-Jin (College of Nursing, Incheon Catholic University)
  • 임수진 (인천가톨릭대학교 간호학과)
  • Received : 2017.01.19
  • Accepted : 2017.04.20
  • Published : 2017.04.28
Download PDF
⟨ Previous Next ⟩

Abstract

This is a convergence study about influences of hematopoietic stem cell transplantation on children growth. For this explanatory survey research, data were collected with medical record of 112 children with malignant and hematological diseases received HSCT from February to March, 2009. To analyze the growth after HSCT, mixed-effects model was used. The mean SDS of height and weight were negative values in HSCT. The mean value of SDS were significantly lower in autologous HSCT group by height(p=0.0008) and weight(p= 0.0012). Significant factors on changes of SDS of height growth were age at HSCT(p=0.0251), autologous HSCT(p=0.0020) and total dose of steroid in allogeneic HSCT (p=0.0403) and age at HSCT(p=0.0042), autologous HSCT(p=0.0035), and duration of TPN(p=0.0159) for weight growth. According to the results, we must learn to recognize the predicting growth impairment after HSCT in children. regarding nursing interventions should be conducted in the care of these children.

본 연구는 소아암 환아의 조혈모세포이식 후 성장을 확인하고, 이에 영향을 미치는 요인들을 조사하고자 진행된 융합연구이다. 2009년 2월부터 3월까지 조혈모세포이식을 받은 소아암 환아 112명의 의무기록으로부터 키와 몸무게를 조사하였으며 자료 분석을 위해 혼합효과 모델을 사용하였다. 연구 결과 조혈모세포이식 후 대상자의 신장과 체중의 표준과의 평균표준편차값이 음의 값이었으며 동종이식 보다 자가이식의 경우 신장(p=0.0008)과 체중(p=0.0012)의 평균이 낮았다. 이식 후 신장에 영향을 주는 것으로 대상자의 이식 시 연령(p=0.0251)과 이식 형태(p=0.0020)가 확인되었으며. 동종이식 환아에서는 성장에 영향을 주는 것으로 스테로이드의 사용량이 확인되었다(p=0.0403). 대상자의 이식 후 체중은 이식 시 연령(p=0.0042), 이식형태(p=0.0035) 그리고 총정맥영양의 주입기간(p=0.0159)에 영향을 받는 것으로 나타났다. 본 연구 결과를 바탕으로 소아암 환아의 조혈모세포이식 후 성장이 잘 이루어질 수 있도록 성장저하의 고위험군을 식별할 수 있도록 하여야하며, 이러한 환아에게 적절한 간호중재가 수행되어야 할 것이다.

Keywords

References

  1. S. M. Shalet, B. Brennan, “Growth and growth hormone status after a bone marrow transplant,” Hormone Research in Paediatrics, Vol. 58, No. 1, pp. 86-90, 2002. https://doi.org/10.1159/000064768
  2. K. C Myers, J. C. Howell, G. Wallace, C. Dandoy, J. El-Bietar, A. Lane, S. R. Rose, “Poor growth, thyroid dysfunction and vitamin D deficiency remain prevalent despite reduced intensity chemotherapy for hematopoietic stem cell transplantation in children and young adults,” Bone marrow transplantation, Vol. 51, No. 7, pp. 980-984, 2016. https://doi.org/10.1038/bmt.2016.39
  3. J. E. Sanders, “Growth and development after hematopoietic cell transplant in children,” Bone marrow transplantation, Vol. 41, No. 2, pp. 223-227, 2008. https://doi.org/10.1038/sj.bmt.1705875
  4. M. A. Skeens, J. McArthur, I. M. Cheifetz, C. Duncan, A. G. Randolph, J. Stanek, R. Bajwa, “High Variability in the Reported Management of Hepatic Veno-Occlusive Disease in Children after Hematopoietic Stem Cell Transplantation,” Biology of Blood and Marrow Transplantation, Vol. 22, No. 10, pp. 1823-1828, 2016. https://doi.org/10.1016/j.bbmt.2016.07.011
  5. D. Simon, C. Fernando, P. Czernichow, A. M. Prieur, “Linear growth and final height in patients with systemic juvenile idiopathic arthritis treated with longterm glucocorticoids,” The Journal of rheumatology, Vol. 29, No. 6, pp. 1296-1300, 2002.
  6. A. Cohen, A. Rovelli, M. T. Van-Lint, C. Uderzo, A. Morchio, C. Pezzini, C. Romano, "Final height of patients who underwent bone marrow transplantation during childhood.," Archives of disease in childhood, Vol. 74 No. 5, pp. 437-440, 1996. https://doi.org/10.1136/adc.74.5.437
  7. A. Cohen, A. Rovelli, B. Bakker, C. Uderzo, van-Lint, H. Esperou, F. Merlo, “Final height of patients who underwent bone marrow transplantation for hematological disorders during childhood: a study by the Working Party for Late Effects-EBMT,” Blood, Vol. 93, No. 12, pp. 4109-4115, 1999.
  8. Z. Huma, F. Boulad, P. Black, G. Heller, C. Sklar, “Growth in children after bone marrow transplantation for acute leukemia,” Blood, Vol. 86, No. 2, pp. 819-824, 1995.
  9. A. Clement-De Boers, W. Oostdijk, M. H. Van Weel-Sipiman, J. den Van den Broeck, J. M. Wit, J. M. Vossen, “Final height and hormonal function after bone marrow transplantation in children,” The Journal of pediatrics, Vol. 129, No. 4, pp. 544-550, 1996. https://doi.org/10.1016/S0022-3476(96)70119-1
  10. E. Y. Park, H. J. Baek, D. K. Han, S. J. Lee, Y. K. Cho, Y. O. Kim, T. J. Hwang, “Final Height of Children after Stem Cell Transplantation,” The Korean Journal of Hematology, Vol. 42, No. 4, pp. 382-391, 2007. https://doi.org/10.5045/kjh.2007.42.4.382
  11. H. H. Jo, M. R. Kim, D. J. Kwon, J. H. Kim, I. K. Sung, J. H. Kim, “Factors Affecting Normal Pubertal Development after bone Marrow Transplantation in Girls,” Korean Journal of Obstetrics and Gynecology, Vol. 47, No. 2, pp. 320-325, 2004.
  12. N. C. Kim, H. S. Kim, S. E. Choi, H. J. Park, “Nutritional status of recipients of allogenic Hematopoietic stem cell transplantaion by type of conditioning regimen,” Journal of Korean Public Health Nursing, Vol. 14, No. 2, pp. 191-202, 2000.
  13. H. R. Glucksberg, R. Storb, A. Fefer, C. D. Buckner, P. E. Neiman, R. A. Clift, E. D. Thomas, “Clinical manifestations of graft-versus-host disease in human recipients of marrow from HLA-matched sibling donors,” Transplantation, Vol. 18, No. 4, pp. 295-304, 1974. https://doi.org/10.1097/00007890-197410000-00001
  14. H. H. Koo, “Solid tumors in childhood: risk-based management,” Korean Journal of Pediatrics, Vol. 50, No. 7, pp. 606-612, 2007. https://doi.org/10.3345/kjp.2007.50.7.606
  15. L. C. Daniel, Y. Li, J. D. Kloss, A. F. Reilly, L. P. Barakat, “The impact of dexamethasone and prednisone on sleep in children with acute lymphoblastic leukemia,” Supportive Care in Cancer, Vol. 24, No. 9, pp. 3897-3906, 2016. https://doi.org/10.1007/s00520-016-3234-y
  16. D. Simon, C. Fernando, P. Czernichow, A. M.. Prieur, “Linear growth and final height in patients with systemic juvenile chronic arthritis treated with long-term glucocorticoids,” The Journal of Rheumatology, Vol. 29, No. 6, pp. 1296-1300, 2002.
  17. K. H. Darzy, S. M. Shalet, “Radiation-induced growth hormone deficiency,” Hormone Research in Paediatrics, Vol. 59, No. 1, pp. 1-11, 2004. https://doi.org/10.1159/000067834
  18. B. Bakker, W. Oostdijk, R. B. Geskus, W. H. Stokvis-Brantsma, J. M. Vossen, J. M. Wit, "Patterns of growth and body proportions after total-body irradiation and hematopoietic stem cell transplanration during childhood," Pediatric research Vol. 59, No. 2, pp. 259-264, 2006. https://doi.org/10.1203/01.pdr.0000199550.71887.ba
  19. A. Papadopoulou, M. D. Williams, P. J. Darbyshire, I. W. Booth, “Nutritional support in children undergoing bone marrow transplantation,” Clinical nutrition, Vol. 17, No. 2, pp. 57-63, 1998. https://doi.org/10.1016/S0261-5614(98)80306-3
  20. J. H. Choe1, Y. J. Lee, H. J. Bae, S. H. Jung, H. J. Hahn, Y. Koh, "Effect of Fish Oil-based Intravenous Fat Emulsion with Parenteral Nutrition in Patients Undergoing Allogeneic Hematopoietic Stem Cell Transplantation" Journal of clinical nutrition, Vol. 8, No. 1, pp. 29-35, 2016. https://doi.org/10.15747/jcn.2016.8.1.29
  21. J. S. Kim, A. H. Eom, M. S. Yu, "Medical Convergence Analysis of Complaint about Medical Service in an Affiliated Hospital" Journal of the Korea Convergence Society, Vol. 7, No. 5, pp. 117-125, 2016. https://doi.org/10.15207/JKCS.2016.7.5.117
  22. B. Min, "An Improvement of Personalized Computer Aided Diagnosis Probability for Smart Healthcare Service System" Journal of Convergence for Information Technology, Vol. 6, No. 4, pp. 79-84, 2016. https://doi.org/10.22156/CS4SMB.2016.6.4.079
  23. Y. Y. Sok, S. H. Kim, "Development of Integrated Infant Care Management App Prototype System in Mobile Environments" Journal of the Korea Convergence Society, Vol. 7, No. 1, pp. 31-36, 2016. https://doi.org/10.15207/JKCS.2016.7.1.031
  24. Y. B. Cho, S. H. Lee, J.H. Park, M. H. Park, "KMMQL-AF-based evaluation of the quality of life for survivors of childhood cancer by age," Journal of Convergence for Information Technology, Vol. 6, No. 3, pp. 71-77, 2016. https://doi.org/10.22156/CS4SMB.2016.6.3.071