Zhongguo shuxue zazhi (Dec 2022)

The clinical outcomes of elderly acute leukemia patients receiving allogenic hematopoietic stem cell transplantation and application of comprehensive nursing care

  • Yanting GU,
  • Feng WEI,
  • Chao MA,
  • Xiaming ZHU,
  • Ting XU

DOI
https://doi.org/10.13303/j.cjbt.issn.1004-549x.2022.12.011
Journal volume & issue
Vol. 35, no. 12
pp. 1235 – 1238

Abstract

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Objective To investigate the clinical outcomes of allogeneic hematopoietic stem cell transplantation in elderly patients with acute leukemia and the role of comprehensive nursing. Methods The data of 52 elderly patients with acute leukemia during the treatment of allogeneic hematopoietic stem cell transplantation were collected. According to the characteristics of elderly patients, 52 patients were given comprehensive nursing measures such as psychological, protective isolation, dietary management and specialized nursing. Stem cell engraftment, transplant complications and survival rates were observed in patients with comprehensive nursing support. Results All patients received comprehensive care. Of the 52 patients, 49 (94.2%) achieved neutrophil engraftment, with a median engraftment time of 12 days (9~19 days), and 45 patients (86.5%) achieved platelet engraftment with a median engraftment time of 13 days (9~35 days). The cumulative incidence of Ⅱ-Ⅳ°acute graft-versus-host disease (GVHD) was 26.9%, and the cumulative incidence of chronic GVHD was 28.5%. Cytomegalovirus (CMV) infection occurred in 15 cases, with a cumulative incidence rate of 37.5%, and Epstein-Barr virus (EBV) infection occurred in 5 cases, with a cumulative incidence rate of 9.9%. Bloodstream bacterial infection occurred in 8 patients with a cumulative incidence of 9.6%. With a median follow-up of 226 days (71~2 365 days), 39 patients survived and 13 died. The 1-year overall survival (OS) was 71.4%, and the OS and disease free survival (DFS) of patients with negative minimal residual disease (MRD) were both 100%. OS and DFS in MRD positive group were 59.2% and 48.1%, respectively. Conclusion Elderly patients with acute leukemia who receive allogeneic hematopoietic stem cell transplantation can also achieve long-term survival. Taking targeted preventive and nursing measures can ensure the success rate of transplantation.

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