Supportive (Maintenance) Therapy in Hematopoietic Stem Cell Transplantation: Main Principles and New Perspectives
Supportive (maintenance) therapy (ST) for hematopoietic stem cell transplantation (HSCT) is undergoing significant changes and development. The aim of the review was to summarise the basic data on methods and perspective of ST for HSCT and to analyse new opportunities and alternative approaches to e...
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| Format: | Article |
| Language: | Russian |
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Practical Medicine Publishing House
2017-10-01
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| Series: | Клиническая онкогематология |
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| Online Access: | http://bloodjournal.ru/wp-content/uploads/2017/10/10_1.pdf |
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| author | VP Pop OA Rukavitsyn |
| author_facet | VP Pop OA Rukavitsyn |
| author_sort | VP Pop |
| collection | DOAJ |
| description | Supportive (maintenance) therapy (ST) for hematopoietic stem cell transplantation (HSCT) is undergoing significant changes and development. The aim of the review was to summarise the basic data on methods and perspective of ST for HSCT and to analyse new opportunities and alternative approaches to enhance the antitumor potential of HSCT. The need for ST is constantly growing as a result of significant increase in the number of performed HSCT and an increase in patient survival. The review highlights traditional methods of ST which allowed to boost the success of HSCT: antibacterial, antifungal, and antiviral preventive treatment. The authors discuss preventing toxicity of dimethyl sulfoxide (cryopreserving agent); understudied aspects of vaccination of HSCT recipients, and effects on microbiota. The study demonstrates that many of the classic recommendations of ST are being constantly updated given the wide variability of approaches not only to post-transplant monitoring, but also to empirical antibiotic therapy and the use of hematopoietic growth factors and the appropriateness of the correction of the microbiota, constraints of the external environment and social contacts. Currently, HSCT is becoming more available, in conditions close to the out-patient clinics, which leads to improved outcomes and significantly decreases the cost of hospital stay. The future improvement of the cost effectiveness and quality of ST will be possible due to health information technologies, and digital infrastructure between doctor and patient. We report our own experience of ST for allo-HSCT in 19 patients and for auto-HSCT in 82 patients, and implementation of auto-HSCT in non-insulated wards without HEPA-filtration. The literature review shows both the increased demand for the various methods of ST at HSCT and its increasing efficiency. Despite the lack of uniform standards, introduction of new approaches of ST should significantly improve HSCT outcomes. |
| format | Article |
| id | doaj-art-d7ed28b5a0cb41abb036bc59b7293aa5 |
| institution | DOAJ |
| issn | 1997-6933 2500-2139 |
| language | Russian |
| publishDate | 2017-10-01 |
| publisher | Practical Medicine Publishing House |
| record_format | Article |
| series | Клиническая онкогематология |
| spelling | doaj-art-d7ed28b5a0cb41abb036bc59b7293aa52025-08-20T03:23:52ZrusPractical Medicine Publishing HouseКлиническая онкогематология1997-69332500-21392017-10-0110450151310.21320/2500-2139-2017-10-4-501-513Supportive (Maintenance) Therapy in Hematopoietic Stem Cell Transplantation: Main Principles and New PerspectivesVP Pop0OA Rukavitsyn1NN Burdenko Main Military Clinical Hospital, 3 Gospitalnaya sq., Moscow, Russian Federation, 105229NN Burdenko Main Military Clinical Hospital, 3 Gospitalnaya sq., Moscow, Russian Federation, 105229Supportive (maintenance) therapy (ST) for hematopoietic stem cell transplantation (HSCT) is undergoing significant changes and development. The aim of the review was to summarise the basic data on methods and perspective of ST for HSCT and to analyse new opportunities and alternative approaches to enhance the antitumor potential of HSCT. The need for ST is constantly growing as a result of significant increase in the number of performed HSCT and an increase in patient survival. The review highlights traditional methods of ST which allowed to boost the success of HSCT: antibacterial, antifungal, and antiviral preventive treatment. The authors discuss preventing toxicity of dimethyl sulfoxide (cryopreserving agent); understudied aspects of vaccination of HSCT recipients, and effects on microbiota. The study demonstrates that many of the classic recommendations of ST are being constantly updated given the wide variability of approaches not only to post-transplant monitoring, but also to empirical antibiotic therapy and the use of hematopoietic growth factors and the appropriateness of the correction of the microbiota, constraints of the external environment and social contacts. Currently, HSCT is becoming more available, in conditions close to the out-patient clinics, which leads to improved outcomes and significantly decreases the cost of hospital stay. The future improvement of the cost effectiveness and quality of ST will be possible due to health information technologies, and digital infrastructure between doctor and patient. We report our own experience of ST for allo-HSCT in 19 patients and for auto-HSCT in 82 patients, and implementation of auto-HSCT in non-insulated wards without HEPA-filtration. The literature review shows both the increased demand for the various methods of ST at HSCT and its increasing efficiency. Despite the lack of uniform standards, introduction of new approaches of ST should significantly improve HSCT outcomes.http://bloodjournal.ru/wp-content/uploads/2017/10/10_1.pdfhematopoietic stem cell transplantationsupportive therapymucositisantibacterialantifungal and antiviral preventive measuresmicrobiotaposttransplant complications |
| spellingShingle | VP Pop OA Rukavitsyn Supportive (Maintenance) Therapy in Hematopoietic Stem Cell Transplantation: Main Principles and New Perspectives Клиническая онкогематология hematopoietic stem cell transplantation supportive therapy mucositis antibacterial antifungal and antiviral preventive measures microbiota posttransplant complications |
| title | Supportive (Maintenance) Therapy in Hematopoietic Stem Cell Transplantation: Main Principles and New Perspectives |
| title_full | Supportive (Maintenance) Therapy in Hematopoietic Stem Cell Transplantation: Main Principles and New Perspectives |
| title_fullStr | Supportive (Maintenance) Therapy in Hematopoietic Stem Cell Transplantation: Main Principles and New Perspectives |
| title_full_unstemmed | Supportive (Maintenance) Therapy in Hematopoietic Stem Cell Transplantation: Main Principles and New Perspectives |
| title_short | Supportive (Maintenance) Therapy in Hematopoietic Stem Cell Transplantation: Main Principles and New Perspectives |
| title_sort | supportive maintenance therapy in hematopoietic stem cell transplantation main principles and new perspectives |
| topic | hematopoietic stem cell transplantation supportive therapy mucositis antibacterial antifungal and antiviral preventive measures microbiota posttransplant complications |
| url | http://bloodjournal.ru/wp-content/uploads/2017/10/10_1.pdf |
| work_keys_str_mv | AT vppop supportivemaintenancetherapyinhematopoieticstemcelltransplantationmainprinciplesandnewperspectives AT oarukavitsyn supportivemaintenancetherapyinhematopoieticstemcelltransplantationmainprinciplesandnewperspectives |