Division of Pediatric Hematology/Oncology, Children's Hospital at Montefiore, Bronx, NY 10467, USA.
Biol Blood Marrow Transplant. 2012 Nov;18(11):1709-15. doi: 10.1016/j.bbmt.2012.05.013. Epub 2012 May 29.
We describe adolescents' and parents' interest in hematopoietic stem cell transplant (HSCT) as a cure for sickle cell disease (SCD) and factors associated with increased interest. We administered a 40 question survey to assess the interest in HSCT in parents and adolescents with HBSS or HBSβ(0) thalassemia. The survey tool assessed factors that may influence interest in HSCT including demographic data, disease severity, views on prognosis, and health-related quality of life (HRQOL). All participants were given a handout on the risks and benefits of an HSCT before completing the survey. One hundred twenty-nine parents and 59 adolescents completed the survey. Forty-five percent of parents (54 of 119) would likely have their child undergo HSCT, and 35% of adolescents (19 of 55) would likely undergo HSCT if it was recommended by their hematologist. Parents of adolescents, as well as adolescent patients with better HRQOL, were more interested in HSCT. Prior exchange transfusion was associated with increased interest in HSCT (62% [23 of 37] versus 38% [29 of 76]; P = .02). The majority of parents believe their child's SCD will get better (66%; [80 of 122]), will not likely prevent their child from achieving life goals (83%; [100 of 121]), and will not shorten their child's lifespan (86%; [102 of 119]). There is strong parent and adolescent interest in HSCT as a cure for SCD. It is concerning that few parents and adolescents believe SCD will negatively impact their prognosis. Education on the potential long-term sequelae of SCD is needed when considering the role for HSCT.
我们描述了青少年和家长对造血干细胞移植(HSCT)作为治疗镰状细胞病(SCD)的兴趣,以及与增加兴趣相关的因素。我们进行了一项 40 个问题的调查,以评估 HBSS 或 HBSβ(0)地中海贫血的父母和青少年对 HSCT 的兴趣。该调查工具评估了可能影响 HSCT 兴趣的因素,包括人口统计学数据、疾病严重程度、对预后的看法以及健康相关生活质量(HRQOL)。在完成调查之前,所有参与者都收到了一份关于 HSCT 风险和益处的传单。129 名家长和 59 名青少年完成了调查。45%的家长(119 名中的 54 名)可能会让他们的孩子接受 HSCT,35%的青少年(55 名中的 19 名)如果他们的血液科医生建议,他们可能会接受 HSCT。青少年的父母,以及 HRQOL 较好的青少年患者,对 HSCT 更感兴趣。先前的换血治疗与对 HSCT 的更高兴趣相关(62%[37 名中的 23 名]与 38%[76 名中的 29 名];P=.02)。大多数父母认为他们孩子的 SCD 会好转(66%[122 名中的 80 名]),不太可能阻止他们的孩子实现生活目标(83%[121 名中的 100 名]),也不会缩短他们孩子的寿命(86%[119 名中的 102 名])。家长和青少年对 HSCT 作为治疗 SCD 的方法有强烈的兴趣。令人担忧的是,很少有父母和青少年认为 SCD 会对他们的预后产生负面影响。在考虑 HSCT 的作用时,需要对 SCD 的潜在长期后果进行教育。