Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA, USA.
Center for International Blood and Marrow Transplant Research, National Marrow Donor Program/Be The Match, Minneapolis, MN, USA.
Bone Marrow Transplant. 2024 May;59(5):653-659. doi: 10.1038/s41409-024-02239-w. Epub 2024 Feb 20.
To understand transplant center recommendations on return-to-school timing and related support for hematopoietic cell transplant (HCT) survivors, we conducted a two-phase, cross-sectional, web-based survey: In Phase I, medical directors of pediatric HCT centers from the National Marrow Donor Program/ Be The Match Registry were asked regarding the availability of a return to school standardized operating procedure (SOP). In Phase II, HCT physician members of the Pediatric Transplantation and Cellular Therapy Consortium were approached to study inter-physician practice variability regarding return to school post-HCT, factors affecting their decision-making, and support provided by HCT centers for return to school. Out of 46 respondents in Phase I (55% response rate), 28 (61%) reported having a SOP. Wide variations in recommendations were noted in 12 received SOPs. In Phase II, 122 physicians (60 centers) responded (30.6% response rate). The majority (60%) recommended autologous HCT recipients return to school within 6 months post-HCT but 65% recommended allogeneic HCT recipients return to school after 6 months or once off immunosuppression. Our findings indicate a lack of consensus within and across HCT centers regarding recommended return to school timing and underscore need for a guideline to standardize this process to ensure patient safety and re-integration into school.
为了了解移植中心关于造血细胞移植(HCT)幸存者返校时间和相关支持的建议,我们进行了两阶段、横断面、基于网络的调查:在第一阶段,国家骨髓供者计划/Be The Match 登记处的儿科 HCT 中心的医学主任被问及是否有返校标准化操作程序(SOP)。在第二阶段,儿科移植和细胞治疗联合会的 HCT 医生成员被邀请研究 HCT 后返校的医生间实践差异、影响他们决策的因素以及 HCT 中心为返校提供的支持。在第一阶段的 46 名受访者中(55%的回复率),28 名(61%)报告有 SOP。在收到的 12 个 SOP 中,注意到建议存在广泛差异。在第二阶段,122 名医生(60 个中心)做出了回应(30.6%的回复率)。大多数(60%)建议自体 HCT 受者在 HCT 后 6 个月内返校,但 65%的建议异体 HCT 受者在 6 个月后或停用免疫抑制剂后返校。我们的发现表明,HCT 中心内部和之间在推荐的返校时间方面缺乏共识,这突显了需要制定指南来规范这一过程,以确保患者安全和重新融入学校。