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Lifetime Data and Concepts
Published in Prabhanjan Narayanachar Tattar, H. J. Vaman, Survival Analysis, 2022
Prabhanjan Narayanachar Tattar, H. J. Vaman
Leukemia is the cancer of body's blood-forming tissues and generally it includes the bone marrow and the lymphatic system. A standard treatment is the bone marrow transplant. Post transplantation, the patient is closely observed until the patient can be declared as “cured”, and this period is called the remission time. The bone marrow transplant is a complex operation and the recovery following the operation is also critical. A transplantation is marked as failure if the patient's leukemia relapses or if death is observed within the remission time. On the other hand, the success of transplantation is guided by the recovery process which in turn depends on two intermediate events: (i) development of acute graft-vs-host disease (GVHD) within the first 100 days and (ii) recovery of platelet count to a level marked as more than 400 million per liter. The recovery course also depends on risk factors such as the time of tranplantation, the leukemia stage, age and gender of the patient, the time from diagnosis to transplantation, etc. Following the surgery, the recovery also depends on variables such as occurrence of acute/chronic graft-vs-host disease (GVHD), return of platelet count to normal levels, return of granulocytes to normal levels, or development of infections. See Section 1.3 of Klein and Moeschberger (2003)[64].
Transportation of Bone Marrow for In Vitro Processing and Transplantation
Published in Adrian P. Gee, BONE MARROW PROCESSING and PURGING, 2020
William E. Janssen, Carlos Lee
The transport of bone marrow, either fresly harvested or cryopreserved in liquid nitrogen, does not compromise in any way the outcome of a bone marrow transplant procedure.10 With the growing number of bone marrow transplant centers, the increasing demand for technically complex ex vivo bone marrow manipulation procedures, and the expansion of unrelated donor marrow transplantation, the need to transport bone marrow is likely to increase.
Oncological effects on the central nervous system
Published in Anju Sahdev, Sarah J. Vinnicombe, Husband & Reznek's Imaging in Oncology, 2020
Posterior reversible encephalopathy syndrome (PRES) was first described in 1996 under the name ‘reversible posterior leukoencephalopathy’. These first cases all had acute neurological symptoms, often seizures, and showed distinctive subcortical vasogenic white matter oedema in the parieto-occipital regions of the brain (11). Since the initial description, the syndrome has been much more widely recognized, in part due to the increased use of neuroimaging. The syndrome can be associated with the use of a wide range of chemotherapeutic and immunosuppressive drugs, as well as being associated with hypertensive episodes, renal dysfunction, sepsis, transplantation, and pre-eclampsia. Patients with leukaemia and lymphoma are particularly at risk as well as those with bone marrow transplants and solid organ transplants (12). The more commonly associated agents include tacrolimus and a number of anti–vascular endothelial growth factor (VEGF) agents (e.g. bevacizumab, sunitinib, vandetanib, axitinib) (13). Chemotherapeutic agents such as cytarabine, cisplatin, and gemcitabine are also recognized associations (14).
Forward and reverse typing discrepancy and crossmatch incompatibility of ABO blood groups: cause analysis and treatment
Published in Hematology, 2023
Hongmei Qiu, Xuechun Wang, Yan Shao
Blood groups of bone marrow transplant patients more closely resemble those of donors as a result of hematopoietic reconstitution of hematopoietic stem cells in recipients [1]. Considering that both donor and recipient red blood cells can be found in the peripheral blood, forward blood group typing is a hybrid technique. Variations in reverse blood group typing are to be expected after a transplant. Using forward and reverse blood group typing, we found that a patient with blood group B could successfully receive a bone marrow transplant from a donor who was typed as blood group O and B in forward and reverse blood group typing, respectively. Our study also included a patient with blood group AB who received a bone marrow transplant from a donor with blood group B. This donor was typed as B and AB in forward and reverse group typing, respectively. Within 4 months of their non-homotypic hematopoietic stem cell transplants, both patients underwent a transformation that rendered ABO blood group typing difficult. Patients with forward and reverse blood group typing discrepancies should have their medical records reviewed to learn more about their diseases, and both the patient and donor involved in the bone marrow transplant should be questioned about their blood types. With this information, it is possible to confidently determine the blood group of the patients and provide them with the correct blood transfusion.
Psychological processing among caregivers of allogeneic bone marrow transplant recipients: Qualitative findings from a longitudinal study
Published in Journal of Psychosocial Oncology, 2023
Kelly Tan, Barbara Fredrickson, Hudson Santos, William Wood, Todd Schwartz, Deborah Mayer
Family and friend caregivers provide important contributions to care of patients receiving an allogeneic bone marrow transplant (BMT). In fact, caregivers are considered so vital that BMT recipients in the United States are required to identify at least one caregiver committed to providing care 24/7 for approximately 12 weeks after transplant.1,6 Caregivers of BMT recipients are at high risk for caregiving-related stress and stress-related health problems including depression, anxiety, fatigue, and cardiovascular disease.3,16,17,20 Trends in earlier discharge of BMT patients to ambulatory care, with the consequent shifting of clinical care responsibilities to caregivers, will further increase the burdens experienced by them.1
Remote Patient Monitoring: The New Frontier in Telemedicine
Published in Oncology Issues, 2022
Ksenia Gorbenko, Alaina Kessler, Mark Liu, Melanie Besculides, Carol Kisswany, Madhu Mazumdar, Cardinale B. Smith
About 1.3 million people in the United States are living with hematological malignancies, namely multiple myeloma, lymphoma, and leukemia.6 Patients with hematological malignancies and those undergoing bone marrow transplant have higher hospitalization and mortality rates compared to patients with solid tumors.7,8 Patients with hematological malignancies are often admitted to the hospital due to acute clinical deterioration, and patients may report feeling unprepared to recognize treatment-related side effects.9,10 The use of telemedicine, specifically remote home monitoring of vital signs, may lead to early recognition of worrisome conditions, such as sepsis, and ultimately lead to earlier intervention and improved patient outcomes.