Alberta Blood and Marrow Transplant Program, University of Calgary and Alberta Health Services, Calgary, AB, Canada.
Bone Marrow Transplant. 2019 Mar;54(3):368-382. doi: 10.1038/s41409-018-0265-7. Epub 2018 Jul 9.
Assessing patient eligibility for hematopoietic stem cell transplantation (HSCT) remains a complex, multifaceted challenge. Among these challenges, the paucity of comprehensive clinical data to guide decision making remains problematic coupled with unclear trade-offs between patient, disease and local HSCT center factors. Moreover, it is unclear that the modification of poor patient characteristics will improve post-HSCT outcomes. However, the use of Comorbidity Indices and Comprehensive Geriatric Assessments helps meet this challenge, but may be limited by overlapping patient characteristics. The increasing consideration for pre-HSCT psychosocial assessments and interventions remains to be studied. Ultimately, the decision to proceed with a HSCT remains interdisciplinary while considering the available evidence discussed in this review.
评估患者是否适合进行造血干细胞移植（HSCT）仍然是一个复杂的、多方面的挑战。在这些挑战中，缺乏全面的临床数据来指导决策仍然是一个问题，同时患者、疾病和当地 HSCT 中心因素之间的权衡也不明确。此外，改善患者特征是否会提高 HSCT 后的结果也不清楚。然而，使用合并症指数和全面老年评估有助于应对这一挑战，但可能受到重叠患者特征的限制。越来越多的人考虑在 HSCT 前进行心理社会评估和干预，但仍需要研究。最终，在考虑本综述中讨论的现有证据的同时，进行 HSCT 的决定仍然是跨学科的。
