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造血细胞移植后返校实践:美国移植中心的调查。

Return to school practices after hematopoietic cell transplantation: a survey of transplant centers in the United States.

机构信息

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.

出版信息

Bone Marrow Transplant. 2024 May;59(5):653-659. doi: 10.1038/s41409-024-02239-w. Epub 2024 Feb 20.

Abstract

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.

摘要

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。

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