• 대한영양사협회학술지
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• 제15권2호
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• pp.168-178
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• 2009

Hematopoietic stem cell tranntation is being widely used in an attempt to treat many hematological diseases such as leukemia, anemia, and lymphoma. To evaluate the success of hematopoietic stem cell transplantation, it is very important to determine how rapidly engraftment occurs. Therefore, this retrospective study was conducted to determine which factors affected the term of engraftment during hematopoietic stem cell transplantation, while focusing on the oral intake status. To accomplish this, 416 patients who underwent transplant operations at St. Mary's hospital from May 2006 to April 2008 were evaluated. The long-term engraftment group was characterized as having longer fasting days and more frequent vomiting, diarrhea, and oral mucositis incidences than the short-term engraftment group. In addition, the inhibitors of oral intake such as vomiting, diarrhea, and oral mucositis developed frequently between the pre-transplantation and 2 weeks after transplantation. A significantly negative correlation was observed between the oral intake volume and the duration of the oral intake inhibitors. A multiple regression analysis revealed that the frequency of vomiting and oral mucositis during hematopoietic stem cell transplantation, the length of hospitalization, and the hematocrit level in the 2 weeks after hematopoietic stem cell transplantation were significant predictors of engraftment. The results of this study could be used to establish a guideline for nutritional assessment, nutritional goals, and nutritional support for patients during hematopoietic stem cell transplantation.

• Clinical and Experimental Pediatrics
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• 제50권7호
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• pp.613-621
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• 2007

Hematopoietic stem cell transplantation (HSCT) has expanded and evolved substantially in the last decades to treat various malignant and nonmalignant diseases. However, the conditioning regimen can lead to transplantation related death by major organ dysfunction, severe infection and bleeding. In the allogeneic setting, graft versus host disease may also develop, making post-transplant management complex. To overcome these problems, new stem cell sources, stem cell mobilizing agents and new skills, nonmyeloablative stem cell transplantation including reduced intensity stem cell transplantation has been introduced in clinical practice, but problems remained so far. Recipients of stem cell transplant may be severely immunocompromised for many months after transplantation. Furthermore, long-term complications (endocrine, metabolic, relapse, second malignancies, etc) can develop. Pediatrician is open called on to participate in the evaluation and consideration of patients for possible transplant and long-term follow-up of HSCT patients. This review is intended as a basic overview of HSCT relevant to general pediatrician.

• 재활간호학회지
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• 제7권2호
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• pp.115-126
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• 2004

Purpose: This study was carried out to accumulate basic data for nursing intervention development by evaluating the stress and emotional status of patients and their families after receiving hematopoietic stem cell transplantation (HSCT), illucidating and analysing related factors in order to decrease the negative effects of HSCT on their emotion. Methods: Data were collected using a questionnaire to 53 HSCT patients and 50 families, who were older than 18 at tertiary-care institutions in Seoul, from January, 2000 to August, 2003. Results: There was a significant score difference in stress (t=-2.302, P<0.05). Correlation between stress and emotional status was statistically significant (r=0.486, P<0.01; r=0, P<0.05). Economical burden of cost had significant effects on stress of patients (F=4.194, P<0.05). The series of emotional status of patients without jobs were higher (T=-2.583, P<0.05). The emotional status of families were influenced by monthly income (F=4.036, P<0.05) and patients' diagnosis (F=3.088, P<0.05). Conclusion : These results suggest that the cares for families should be considered with great concern as well as the ones for patients. In addition, such factors as economical burden by medical cost, monthly income and job status should not be excluded in transplantation nursing plans.

• 대한간호학회지
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• 제44권5호
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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.

• Child Health Nursing Research
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• 제12권4호
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• pp.441-450
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• 2006

Purpose: The purpose of this study was to investigate the physical conditions and social adaptation of children who have undergone hematopoietic stem cell transplantation. Methods: The participants in this descriptive survey were 37 children who had undergone hematopoietic stem cell transplantation at least one year ago. Data were collected through observation and questionnaires and processed with the SAS program. Results: Compared to the time of diagnosis, WBC, RBC and platelet counts had increased significantly. The children were taller than at the transplantation stage, but there was no change in weight and 73% of the children had physical symptoms. Boys who were between 6 to 11 years of age had lower rates of socialization and academic progress than normal Korean boys. Boys between 12 to 17 years of age had higher rates of socialization, but lower rates of academic progress. Girls between 6 to 17 years of age scored lower than normal Korean girls in both categories. Conclusion: The above findings indicate that children who have undergone hematopoietic stem cell transplantation try hard to participate in everyday activities. Therefore nursing interventions to improving normal growth and development and facilitate social adaptation should be provided for them.

• Child Health Nursing Research
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• 제15권2호
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• pp.190-200
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• 2009

Purpose: This study was done to investigate the educational needs of families of children who underwent hematopoietic stem cell transplantation and to compare these needs with the educational importance as perceived by nurses. Methods: The participants were 44 families of children who underwent hematopoietic stem cell transplantation and 50 nurses who cared for these children. Data was collected through self-report questionnaires which included items on educational needs and the degree of educational importance. The data was analyzed using the SPSS/WIN program. Results: The educational needs of families before and after transplantation were high, with items on disease and treatment, and direct care ranked as most important, respectively. The degree of educational importance as perceived by nurses was different from that of families. Conclusion: The findings indicate that the educational needs of families before hematopoietic stem cell transplantation were different from those after the procedure. Also, the perception of educational importance was different for families compared to nurses. Therefore nursing education programs based on the educational needs of families should be provided.

• Journal of Yeungnam Medical Science
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• 제19권1호
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• pp.11-27
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• 2002

Allogenic hematopoietic stem cell transplantation is one of the effective therapy for several hematologic malignancies. Transplantation preparative regimen is designed to eradicate the patient's underlying disease and immunosuppress the patient adequately to prevent rejection of donor's hematopoietic stem cells. So, conventional myeloablative preparative regimens with high-dose chemotherapy or radiotherapy are related to high rate of morbidity and mortality. However, It has become clear that the high-dose therapy dose not eradicate the malignancy in some patients, and that the therapeutic benefit of allogenic transplantation is largely related to graft-versus-leukemia/graft-versus-tumor (GVL/GVT) effect. An new approach is to utilize less toxic, nonmyeloablative preparative regimens to achieve engraftment and allow GVL/GVT effects to develop. This strategy reduces the risk of treatment-related mortality and allows transplantation for elderly and those with comorbidities that preclude high-dose chemoradiotherapy.

• IMMUNE NETWORK
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• 제7권3호
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• pp.149-157
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• 2007

Background: The microsatellites within human leukocyte antigen (HLA) region show considerable polymorphism and strong linkage disequilibrium (LD) with HLA alleles. These microsatellites have been used for genetic analysis including disease mapping to understand susceptibility to autoimmune and infectious diseases. Also, use of microsatellites has recently been proposed as an approach for identifying non-HLA markers within the HLA region that could function as transplantation determinants and for the selection of potential donors for transplantation. Methods: To analyse the frequency of five microsatellites in the Korean population, genotyping for polymorphisms at five microsatellites markers (BAT2, MIB, DQCAR, D6S105 and TNFd) within HLA region was performed on 143 healthy Korean controls. Results: The most frequent genotype shown in healthy Korean controls were BAT2 8 (153 bp, 42.7%), MIB 1 (326 bp, 40.6%), DQCAR 3 (188 bp, 38.5%), D6S105 7 (126 bp, 58.0%) and TNFd 3 (128 bp, 58.0%). And common two-loci haplotypes were found as MIB 1-HLA-B*62 (HF: 10.6%), MIB 6-HLA-B*44 (HF: 7.8%), DQCAR 3-HLA-DRB1*13 (HF: 8.5%), TNFd 5-HLA-B*62 (HF: 7.8%) and D6S105 7-HLA-A*02 (HF: 16.2%). Conclusion: These data might provide useful information on the microsatellites markers with HLA region in Korean population and be helpful in further defining the clinical impact of these microsatellites.

• Tuberculosis and Respiratory Diseases
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• 제66권2호
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• pp.122-126
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• 2009

조혈모세포이식 후 1년 이내에 발생하는 폐 합병증의 진단 및 분류는 확립되어 있으나, 수 년 이상 장기간 생존자에게서 발생하는 폐 합병증에 대해서는 잘 알려져 있지 않다. 저자들은 8년 전 동종 조혈모세포이식을 시행받고, 호흡곤란을 주소로 내원한 18세 여자 환자에서, 폐조직 생검을 통해 비분류성 간질성 폐렴을 진단하였으나, 스테로이드 치료에도 불구하고 급격한 악화를 보여 호흡부전으로 사망한 1예를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

• BMB Reports
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• 제57권8호
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• pp.352-362
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• 2024

Hematopoietic stem cell transplantation (HSCT) remains an indispensable therapeutic strategy for various hematological diseases. This review discusses the pivotal role of bone marrow (BM) niches in influencing the efficacy of HSCT and evaluates the current animal models, emphasizing their limitations and the need for alternative models. Traditional animal models, mainly murine xenograft, have provided significant insights, but due to species-specific differences, are often constrained from accurately mimicking human physiological responses. These limitations highlight the importance of developing alternative models that can more realistically replicate human hematopoiesis. Emerging models that include BM organoids and BM-on-a-chip microfluidic systems promise enhanced understanding of HSCT dynamics. These models aim to provide more accurate simulations of the human BM microenvironment, potentially leading to improved preclinical assessments and therapeutic outcomes. This review highlights the complexities of the BM niche, discusses the limitations of current models, and suggests directions for future research using advanced model systems.