Haematological Malignancies - Stem Cell Transplant Flashcards
what needs to be considered
previous lines of trt
would they be fit enough
whether or not a human leukocyte antigen matched donor is available
understanding the procedure + risks vs benefit
improving outcomes with newer trt
risk of higher transplant mortality and morbidity vs potential long term PFS
is it a chemo sensitive disease
how GvHD gets worse with age and other complications
when is it used
MM
lymphoma
leukaemia
severe aplastic anaemia [BM failure]
certain blood, immune system + metabolic disorders - sickle cell anaemia, thalassaemia, severe combined immunodeficiency [SCID], nand hurler syndrome
why is it used
chemo not working or not tolerating it [might mean not fit enough]
relapsed from previous remission
MM to prolong life
what is peripheral neuropathy
chemo induced
tingling in hands/feet
muscle weakness, unable to feel extreme temp, motor skill reduction
shooting pain
when does acute GvHD
within 100 days of transplant, common 2-3 weeks when new BM begins to make blood cells (engraftment)
what is GvHD
rash which is itchy, painful starts on the hands, feet, ears, face
what can GvHD cause
gut issues
- inflammation of bowel
- diarrhoea
- pain
- vomiting
- weight-loss
when is chronic GvHD
more than 100 days post transplant can last several months or years
where can chronic GvHD be found
skin, gut, liver, mouth, eyes, lung, genitals, penis, vulva, joints
what is the psychosocial impact of blood cancer diagnosis
PTSD
isolating
constant anxiety
low self esteem
depression and suicide
frustrated and fed up
difficulty in intimacy due to GvHD
what does allogenic mean
one person to another
what does autologous mean
removing own SC, transplanting them in later when pt is in remission
leukaemia SE
nausea
vomiting
diarrhoea
fatigue
hair loss
risk of infection
rashes
brain fog
sleep aponea
body changes
mucositis
peripheral neuropathy
GvHD
what is leukaemia LE dependent on
drugs and other conditions
LE for leukaemia
cognitive: concentration, memory
heart conditions
thyroid issues
osteoporosis
infertility
hearing loss/tinnitus
fatigue
what are the rare types of leukaemia
mast cell
prolymphocytic leukaemia
large granular lymphocytic
hairy cell [HCL]- splenectomy, chemo is the main treatment option
HCL-V
APL
what is APL
acute promyelocytic leukaemia
subtype of AML
most treatable subtype
might just need short cycles of chemo
what is HCL-V
variant of hairy cell
different genetic make up
respond differently to trt
