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Hematopoietic Cell Transplants
  • Concepts, Controversies and Future Directions
  • Edited by Hillard M. Lazarus, Robert Peter Gale, Armand Keating, Andrea Bacigalupo, Reinhold Munker, Kerry Atkinson
  • Edited in association with Syed Ali Abutalib
  • Published online:
    24 May 2017
    Print publication:
    01 January 2000
  • This authoritative new book provides a comprehensive overview of diagnostic and therapeutic strategies in hematopoietic cell transplantation, explaining key concepts, successes, controversies and challenges. The authors and editors discuss current and future strategies for major challenges, such as graft-versus-host-disease, including new prophylaxis and treatments. They also discuss long-term complications, such as second malignancies and cardiovascular complications. Chapters are written by leading world experts, carefully edited to achieve a uniform and accessible writing style. Each chapter includes evidence-based explanations and state-of-the-art solutions, providing the reader with practice-changing advice. Full reference lists are also supplied to facilitate further exploration of each topic. Each copy of the printed book is packaged with a password, giving readers online access to all text and images. This inspiring resource demystifies both the basics and subtleties of hematopoietic cell transplantation, and is essential reading for both senior clinicians and trainees.

  • Supportive care with art therapy, for patients in isolation during stem cell transplant

  • Alessandra Agnese, Teresa Lamparelli, Andrea Bacigalupo, Paola Luzzatto
  • Journal:
    Palliative & Supportive Care / Volume 10 / Issue 2 / June 2012
    Published online by Cambridge University Press:
    22 March 2012, pp. 91-98
  • Objective:

    The aim of the art therapy study was twofold: 1) to identify the specific factors of the art therapy experience perceived as helpful by patients undergoing an allogenic hemopoietic stem cell transplant (HSCT); and 2) to establish an appropriate criterion for referral to art therapy among this population.

    Method:

    Between 2006 and 2010, a dedicated art therapist met all the patients who were referred to her by the hematologist. The art therapy approach and techniques are described. Outcome was evaluated by self-assessment, based on written questionnaires that were given to the patients before discharge.

    Results:

    Seventy-four patients followed the weekly individual sessions during isolation and filled out the questionnaire. All of them defined the art therapy experience as “helpful” and specified in which way it had been helpful. Through a thematic analysis of the patients' written comments, three specific aspects of art therapy, which the patients found most helpful, were identified: (1) being able to calm down from anxiety, through the use of art therapy techniques (77.02%); (2) feeling free to express and share difficult feelings, which they had not communicated verbally (75.67%); and (3) establishing meaningful connections with their loved ones, through images made in art therapy (36.48%). Case illustrations are provided.

    Significance of results:

    The results suggest that referral to art therapy from the team might be helpful and appropriate: (1) when patients are anxious; (2) when they are uncommunicative and hide their feelings; and (3) when they feel disconnected from their loved ones at home.

Aplastic Anemia
  • Pathophysiology and Treatment
  • Edited by Hubert Schrezenmeier, Andrea Bacigalupo
  • Published online:
    18 August 2009
    Print publication:
    11 November 1999
  • This book takes account of the most recent findings in laboratory research and clinical trials to provide a comprehensive and up-to-date reference on the pathophysiology, epidemiology, diagnosis and treatment of acquired and inherited aplastic anemia. As well as a detailed overview of the pathophysiology of the disease, the international team of authors cover all aspects of management, including the established approaches of bone marrow transplantation and immunosuppressive treatment, new approaches such as the use of hematopoietic growth factors and escalated immunosuppression, and controversial issues such as stem cell transplantation. Also included is an important international consensus document on treatment, and a final section concentrates on the inherited syndrome Fanconi's anemia. Detailed treatment guidelines are given, making this the definitive resource for hematologists and other clinicians involved in the management and supportive care of patients with aplastic anemia. Scientists interested in bone marrow failure will also find this an invaluable reference.

  • 11 - Prevention of Chronic Graft versus Host Disease

  • from PART II - CLINICAL MANAGEMENT
  • Edited by Georgia B. Vogelsang, The Johns Hopkins University School of Medicine, Steven Z. Pavletic, National Cancer Institute, Bethesda, Maryland
  • Book:
    Chronic Graft Versus Host Disease
    Published online:
    26 August 2009
    Print publication:
    20 April 2009, pp 117-123

  • Summary

    INTRODUCTION

    Chronic graft versus host disease (GVHD) is the major complication in long-term survivors of an allogeneic hematopoietic stem cell transplant (HSCT): its detrimental effect on quality of life, especially when extensive or severe, together with its protective role on leukemia relapse are well documented. This chapter will outline programs designed to prevent GVHD, including the use of agents capable of modulating T-cell function. Recent developments in our understanding of the sclerodermatous form of chronic GVHD (cGVHD) and its clinical implications will also be discussed.

    TIMING OF CHRONIC GVHD

    This division on day 100 between acute and cGVHD is currently considered artificial. With the advent of nonmyeloablative hematopoietic cell transplantation (HCT) regimens and the use of unrelated donor stem cells, there is a need to drop this arbitrary time point from the definition of these disease entities. Current studies are more likely to utilize the clinical manifestations of these diseases rather than the arbitrary cutoff of a particular date post transplantation. This has been the conclusion of an international group of experts.

    A continuum of clinical findings (i.e., “overlap syndrome”) may be observed in patients with acute and cGVHD, as both disorders commonly affect similar organs, principally the skin, liver, and gastrointestinal tract. However, the target organs affected by and the clinical and histologic features associated with cGVHD may differ from those observed with acute disease. As an example, autoimmune phenomena, such as autoantibody formation, are more common with chronic disease.

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