• Title/Summary/Keyword: 조혈모세포 이식

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Analysis of Acute Kidney Injury in Pediatric Patients with Stem Cell Transplantation (소아에서 조혈모세포이식 후 급성 신질환의 분석)

  • Kim, Sae-Yoon;Choi, Jung-Youn;Ha, Jeong-Ok;Park, Yong-Hoon
    • Childhood Kidney Diseases
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    • v.13 no.2
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    • pp.130-137
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    • 2009
  • Purpose : Stem cell transplantation (SCT) has gained worldwide acceptance as a treatment for hematologic disorders. This study was performed to evaluate the clinical characteristics and outcomes of the acute kidney injury after SCT in children. Methods : The records of 53 patients who were treated with SCT at the pediatric department of Yeungnam University Hospital between January, 1996 and April, 2009 were used as subjects. Their were divided into two groups ; 'Early renal insufficiency' (ERI, n=18) and 'Non-early renal insufficiency' (NERI, n=35). ERI had greater than 25% of drop in GFR after SCT. Results: Total 53 patients were analyzed. In cord blood SCT (n=11), ERI was 4 (36.4%) and NERI was 7 (63.6%). In bone marrow SCT (n=16), ERI was 8 (50.0%) and NERI was 8 (50.5%). In autologous peripheral blood SCT (n=26), ERI was 6 (23.1%) and NERI was 20 (76.9%). There is no difference in both groups according to kinds of SCT. GVHD was developed in 22 patients, and there is no difference in each group. Twenty two of 53 patients died. ERI was 12 (66.7%) and NERI was 10 (28.6%). Acute renal failure is most important cause of the deaths. Conclusion : Out of 53 pediatric patients who were treated with SCT, 18 patients had greater than 25% of drop in GFR. There is no difference in both groups according to kinds of SCT. GVHD was found in 22 patients and there is no relation between GVHD development and acute kideney injury.

Perceived Anxiety and Uncertainty in Hematopoietic Stem Cell Transplantation Recipients to and from Isolation Unit (격리병동 입.퇴실시 조혈모세포 이식 환자가 지각하는 불안과 불확실성)

  • Kim, Hye-Jo;Choi, Dong-Won;Park, Ho-Ran;Sohng, Kyeong-Yae
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.13 no.3
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    • pp.428-436
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    • 2006
  • Purpose: To investigate the levels of uncertainty and anxiety at admission and discharge to the isolation unit for patients undergoing hematopoietic stem cell transplantation (HSCT). Method: The data were collected from 60 patients who were admitted to the department of HSCT. Uncertainty and anxiety were assessed using the Mishel Uncertainty in Illness Scale (MUIS) and Anxiety Inventory (STAI). Collected data were analyzed using the SAS program. Results: The mean score for anxiety at admission was 2.20, and at discharge 2.10. The mean score for uncertainty at admission was 2.19, and at discharge 2.07. The anxiety at admission the group with physical discomfort was higher than that of group without physical discomfort. A positive relationship was found between anxiety and uncertainty at admission and at discharge. The major variables were expectation for cure and physical discomfort, explaining 25.87% of the anxiety at admission. The major variable was expectation for cure, explaining 20.94% of the uncertainty at admission. Conclusion: Front the above results, it can be concluded that support and consideration are required to reduce anxiety of the inpatient in single room.

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Unrelated stem cell transplantation after reduced-intensity conditioning plus rituximab for Epstein-Barr virus-associated hemophagocytic lymphohistiocytosis with CNS involvement (저강도 전처치와 rituximab 후 타인 조혈모세포 이식을 시행한 중추신경계를 침범한 Epstein-Barr 바이러스 관련 혈구포식 림프조직구증)

  • Baek, Hee Jo;Kook, Hoon;Han, Dong Kyun;Lee, Min-Cheol;Jeong, Tae Woong;Hwang, Tai Ju
    • Clinical and Experimental Pediatrics
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    • v.52 no.6
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    • pp.725-729
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    • 2009
  • Epstein-Barr virus-associated hemophagocytic lymphohistiocytosis (EBV-HLH) with central nervous system (CNS) involvement is usually fatal unless stem cell transplant (SCT) is offered. However, SCT with conventional intensity conditioning is associated with high transplant-related mortality. We describe our experience with unrelated SCTs after reduced-intensity conditioning (RIC) for patients with EBV-HLH with progressive CNS disease. This approach was associated with minimal toxicities and might be an effective option in patients with EBV-HLH with progressive CNS disease. Moreover, the addition of rituximab to RIC appears to be safe and effective in suppressing EBV in the patients with EBV-HLH.

Stress, Coping, and Depression in Patients Following Hemopoietic Stem Cell Transplantation (조혈모세포이식 환자의 스트레스, 대처 및 우울)

  • Kim, Kyung-Eon;Yoo, Yang-Sook
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.13 no.3
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    • pp.437-446
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    • 2006
  • Purpose: This study was done to identify the level of stress, coping, and depression among hemopoietic stem cell transplantation patients who received care in an outpatient center. Method: Data were collected from 81 patients who underwent hemopoietic stem cell transplantation at C University S Hospital between August 2005 and February 2006. Results: Stress and depression were significantly higher following hemopoietic stem cell transplantation in women, and in patients who were worse off financially or who were in bad health. The highest item of stress was 'economic burden for treatment'. There were significantly higher levels of emotion-focused coping among patients who had a spouse and who received motivation from the doctor. The highest item for problem-focused coping was 'try to look at the bright side of life'. The highest items for emotion-focused coping were to 'have faith that treatment will be finished quickly' and 'believe that your situation will improve'. Stress was significantly correlated with depression among these patients. Conclusion: It is necessary to develop nursing interventions to enhance positive coping and to decrease stress and depression among patients who have a hemopoietic stem cell transplantation.

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Quality of Life in Patients with Hematopoietic Stem Cell Transplant (조혈모세포 이식환자의 삶의 질)

  • Song, Byung-Yun;Kang, Hye-Ryeong;Kim, Kwang-Sung
    • Asian Oncology Nursing
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    • v.8 no.1
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    • pp.40-49
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    • 2008
  • Purpose: This descriptive study was to investigate the quality of life in patients with hematopoietic stem cell transplantation (HSCT) from June 1 to October 13, 2007. Method: The survey was conducted in 6 different university hospitals which located in Seoul and Jeollanam-do province using the Functional Assessment of Cancer Therapy-BMT Scale (FACT-BMT) version 4. We collected a total of 155 questionnaires and analyzed 149 among them. Results: The average score of quality of life was 2.53 out of 5. Physical well being score was highest among sub-domains, followed by emotional well-being, additional concerns, social/family well-being, and functional well-being. Study subjects worried that their conditions would get worse. However study subjects didn't regret having been received HSCT. Age, duration from HSCT, age at diagnosis, income, readmission, HSCT type, educational background, marital status, and the level of activities of daily living were related to quality of life. Conclusions: The findings of this study indicates that the HSCT survivor's quality of life issue is still important and have to be investigated repeatedly in the future. That is necessary for generalizing QOL outcomes for clinical use. We also suggest to develop interventions to improve QOL.

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Incidence and Factors Influencing Oral Mucositis in Patients with Hematopoietic Stem Cell Transplantation (조혈모세포이식 환자의 구강 점막염 발생실태와 영향요인)

  • Jo, Kwan Suk;Kim, Nam Cho
    • Journal of Korean Academy of Nursing
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    • v.44 no.5
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    • pp.542-551
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    • 2014
  • Purpose: This study was done to examine the incidence of oral mucositis in hematopoietic stem cell transplantation patients and to identify factors influencing oral mucositis and patient outcomes according to severity. Methods: In this retrospective study, data were collected from electronic medical records of 222 patients who had received hematopoietic stem cell transplantation. Oral mucositis was evaluated using WHO's assessment scale. Data were analyzed using Chi-square test, Fisher exact test, Spearman's correlation, Ordinal logistic regression, ANOVA and Kruskal-Wallis test. Results: A total of 69.8% of the patients evaluated developed oral mucositis (grade II and over). As a results of ordinal regression, factors influencing oral mucositis severity were found to be diagnosis, type of transplantation, oxygen inhalation and the number of antiemetics administration before transplantation. The severity of oral mucositis was found to increase the days of hospitalization, days of TPN administration, days of using antibiotics and the number and dosage of analgesics. Conclusion: The results would help predict severity of oral mucositis in hematopoietic stem cell transplantation patients and suggest that provision of appropriate nursing assessment and oral care would improve patient outcomes.

Insomnia in Patients with Hematopoietic Stem Cell Transplantation(HSCT) (조혈모세포 이식 환자의 불면증)

  • Lee, Sang-Shin;Kim, Hyunseuk
    • Journal of the Korean society of biological therapies in psychiatry
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    • v.24 no.3
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    • pp.142-155
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    • 2018
  • Insomnia in patients with hematopoietic stem cell transplantation(HSCT) has been underdiagnosed and undertreated. This study reviewed the frequency, characteristics, physical and psychological effects, and treatments of insomnia in HSCT patients to highlight clinical importance in this specialized population. Furthermore, the authors intended to suggest a model that would conceptualize insomnia in the context of HSCT. In the pre-transplant period, about half of patients with HSCT suffered from sleep disturbance. A substantial number of patients experienced distressing insomnia during the HSCT procedure and recovered to the level of the pre-transplant period. However, sleep disruption could be a chronic symptom in HSCT survivors and could negatively impact quality of control, cancer-related fatigue(CRF), immune function, and psychological distress. The 3P's model(Predisposing, Precipitating, Perpetuating) explains insomnia in cancer population and could be also relevant to HSCT patients with specific consideration of CRF, graft-versus-host diseases, specific properties of hematological disease, and protective isolated milieu. Effective treatment of insomnia in HSCT includes non-pharmacological(e.g., cognitive behavioral therapy, environmental modification) and pharmacological interventions. The decision of pharmacological treatment should be based on the issue of safety due to high risk of potential drug-drug interactions. Screening, treatment, and further research of insomnia in HSCT patients using validated subjective and/or objective measures are warranted.

Megakaryocyte Colony Formation of Fetal Liver Cells (태아 간세포의 거핵구 집락형성)

  • Kwon, Byung O;Ju, Hye Young;Kim, Chun Soo;Jeon, Dong Seok;Kim, Jong In;Kim, Heung Sik
    • Clinical and Experimental Pediatrics
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    • v.45 no.2
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    • pp.247-255
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    • 2002
  • Purpose : This study was undertaken to obtain basic data about the megakaryocyte colony formation of fetal liver cells by using immunocytochemical staining and ex vivo culture with growth factors. Methods : The mononuclear cells were isolated from fetal liver and bone marrow with idiopathic thrombocytopenic purpura(ITP) and pancytopenia. These mononuclear cells were cultured in $MegaCult^{TM}-C$(Stem Cell Tech, Canada) media in the presence of growth factors and CFU-Megakaryocyte( CFU-Mk) colonies were counted on day 12. The expansion of CD34+ and CD41+ cell was analyzed by flow cytometry after 5 days incubation using flask culture. Results : The numbers of CFU-Mk colonies of mononuclear cells obtained from fetal liver in the 11th week gestational age were more than those in the 19th week specimens; growth factors could not enhance the colony expansion in all cases. Total numbers of CFU-Mk colony of fetal liver cells were higher than bone marrow from ITP or pancytopenia groups. The numbers of pure or large CFU-Mk colonies of fetal liver cells were also higher than bone marrow specimens. The rate of CD34+ cell expression of fetal liver was increased after flask culture and the enhancement effect of epression was seen only in cases which added thrombopoietin. The rate of CD41+ cell expression of fetal liver was increased after incubation, but the enhancement effect of growth factors was unclear. Conclusion : This study revealed good results about the megakaryocyte colony assay of fetal liver mononuclear cells using $MegaCult^{TM}-C$ media. This study suggests that the fetal liver could be a good source of megakaryocytic progenitor cells for clinical application in hematopoietic stem cell transplantation.

Desmoplastic Small Round Cell Tumor of the Mediastinum -A case report - (종격동에 발생한 결합조직형성 소원형세포 종양 - 1예 보고-)

  • Kim, Jeong-Won;Cha, Hee-Jeong;Park, Sang-Kyu;Jung, Jong-Pil;Shin, Je-Kyoun;Park, Chang-Ryul
    • Journal of Chest Surgery
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    • v.40 no.2 s.271
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    • pp.147-150
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    • 2007
  • Desmoplastic small round cell tumor (DSRCT) is rare and a recently described, poorly differentiated malignant tumor and it usually presents with widespread intra-abdominal involvement. We report a case of DSRCT arising form the mediastinum which was treated with multimodality anticancer therapy in 15 year-old girl.

Total Body Irradiation of Childhood Leukemia dose Evaluation due to Changes in the Thickness of the Tissue Compensators (소아백혈병의 전신방사선조사 시 조직보상체의 두께변화에 따른 선량평가)

  • Lee, Dong-Yeon;Kim, Chang-Soo;Kim, Dong-Hyun;Kim, Jung-Hoon
    • The Journal of the Korea Contents Association
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    • v.14 no.4
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    • pp.249-255
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    • 2014
  • Total body irradiation use one of the pre-treatment as hematopoietic stem cell transplantation in the treatment of leukemia. According to the study of Korean network for organ sharing 2013 report, continue to increase the number of hematopoietic stem cell transplantation. however, the current dose evaluation fall short before treatment. So purpose of this study is Surface dose and deep organ dose evaluation and then find the most ideal conditions when change of the thickness on tissue compensator in TBI. Result, surface dose in 4 MV, SSD 280 cm, compensators thickness 0.5 cm, was measured the highest dose 5.84 mGy/min. And the ideal dose showed when compensator thickness less than 1 cm.