Faculty of Medicine and Cologne University Hospital, Department of Palliative Medicine, University of Cologne, 50924, Cologne, Germany.
Faculty of Medicine and Cologne University Hospital, Center for Integrated Oncology Aachen-Bonn-Cologne-Duesseldorf (CIO ABCD), University of Cologne, Cologne, Germany.
Ann Hematol. 2021 Jun;100(6):1377-1389. doi: 10.1007/s00277-021-04538-4. Epub 2021 May 6.
Patients undergoing allogeneic stem cell transplantation (allo-SCT) are given a real chance of cure, but at the same time are confronted with a considerable risk of mortality and of severe long-term impediments. This narrative, non-systematic literature review aims to describe the supportive and palliative care needs of allo-SCT recipients, including long-term survivors or those relapsing or dying after transplantation. It also evaluates the feasibility and effectivity of integrating palliative care early in transplant procedures. In this appraisal of available literature, the main findings relate to symptoms like fatigue and psychological distress, which appear to be very common in the whole allo-SCT trajectory and might even persist many years post-transplantation. Chronic GvHD has a major negative impact on quality of life. Overall, there is a paucity of research on further issues in the context of allo-SCT, like the distress related to the frequently unpredictable post-transplant trajectory and prognosis, as well as the end-of-life phase. First randomized controlled results support the effectiveness of early integration of specialized palliative care expertise into transplant algorithms. Barriers to this implementation are discussed.
接受异基因干细胞移植（allo-SCT）的患者有治愈的真正机会，但同时也面临着相当大的死亡风险和严重的长期障碍。本叙事性、非系统性文献综述旨在描述 allo-SCT 受者的支持和姑息治疗需求，包括长期幸存者或移植后复发或死亡者。它还评估了在移植过程中早期整合姑息治疗的可行性和有效性。在对现有文献的评估中，主要发现与疲劳和心理困扰等症状有关，这些症状在整个 allo-SCT 过程中似乎非常常见，甚至在移植后多年仍可能持续存在。慢性 GvHD 对生活质量有重大负面影响。总体而言，allo-SCT 背景下的其他问题研究相对较少，例如与移植后轨迹和预后经常不可预测相关的困扰，以及生命末期阶段。初步随机对照结果支持将专门的姑息治疗专业知识早期纳入移植算法的有效性。讨论了实施这一措施的障碍。
