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1.
Bull Cancer ; 111(2S): S67-S77, 2024 Feb.
Artigo em Francês | MEDLINE | ID: mdl-37169605

RESUMO

Allogeneic hematopoietic stem cell transplantation (HCT) and CAR-T cells therapy are treatments with curative aim for certain hematological malignancies, refractory or relapse. Nevertheless, they carry the risk of morbidity and mortality and may have a significant psychosocial impact, particularly for HCT. It is therefore necessary to identify psychological difficulties and social problems, as well as the patient's resources, and those of his entourage, in order to improve his overall management. The objective of this evaluation is not to pose contraindications to treatments, but to adapt the personalized care project. This identification must be carried out early on in the pre-HCT assessment journey to enable the implementation of appropriate actions by the various care providers. Based on a review of the literature, we designed a psychosocial data collection grid that can be initiated in pre-transplant and updated by accompanying the patient at each stage of follow-up (discharge from hospital, day-hospital follow-up, D100 evaluation). This grid is divided into 3 axes: socio-family context, psychological and somatic aspects. This tool allows the traceability of the interventions of different professionals and is a support for multidisciplinary exchanges.


Assuntos
Transplante de Medula Óssea , Transplante de Células-Tronco Hematopoéticas , Humanos , Vulnerabilidade Social , Recidiva Local de Neoplasia , Sociedades Médicas , Linfócitos T
2.
Bull Cancer ; 110(2S): S13-S29, 2023 Feb.
Artigo em Francês | MEDLINE | ID: mdl-36307324

RESUMO

The advent of new technologies has made it possible to identify genetic predispositions to myelodysplastic syndromes (MDS) and acute leukemias (AL) more frequently. The most frequent and best characterized at present are mutations in CEBPA, RUNX1, GATA2, ETV6 and DDX41 and, either in the presence of one of these mutations with a high allelic frequency, or in the case of a personal or family history suggestive of blood abnormalities such as non-immune thrombocytopenia, it is recommended to look for the possibility of a hereditary hematological malignancy (HHM). Indeed, early recognition of these HHMs allows better adaptation of the management of patients and their relatives, as allogeneic hematopoietic stem cell transplantation (HSCT) is very often proposed for these pathologies. According to current data, with the exception of the GATA2 mutation, the constitutional or somatic nature of the mutations does not seem to influence the prognosis of hematological diseases. Therefore, the indication for an allograft will be determined according to the usual criteria. However, when searching for a family donor, it is important to ensure that there is no hereditary disease in the donor. In order to guarantee the possibility of performing the HSC allograft within a short period of time, it may be necessary to initiate a parallel procedure to find an unrelated donor. Given the limited information on the modalities of HSC transplantation in this setting, it is important to assess the benefit/risk of the disease and the procedure to decide on the type of conditioning (myeloablative or reduced intensity). In view of the limited experience with the risk of secondary cancers in the medium and long-term, it may be appropriate to recommend reduced intensity conditioning, as in the case of better characterized syndromic hematological diseases such as Fanconi anemia or telomere diseases. In summary, it seems important to evoke HHM more frequently, particularly in the presence of a family history, certain mutations or persistent blood abnormalities, in order to discuss the specific modalities of HSC allografting, particularly with regard to the search for a donor and the evaluation of certain modalities of the procedure, such as conditioning. It should be noted that the discovery of HHM, especially if the indication of an allogeneic HSC transplant is retained, will raise ethical and psychological considerations not only for the patient, but also for his family. A multidisciplinary approach involving molecular biologists, geneticists, hematologists and psychologists is essential.


Assuntos
Doenças Hematológicas , Neoplasias Hematológicas , Transplante de Células-Tronco Hematopoéticas , Leucemia , Humanos , Predisposição Genética para Doença , Neoplasias Hematológicas/genética , Neoplasias Hematológicas/terapia , Transplante de Células-Tronco Hematopoéticas/métodos , Leucemia/genética , Leucemia/terapia , Condicionamento Pré-Transplante/métodos
3.
Bull Cancer ; 108(12S): S1-S9, 2021 Dec.
Artigo em Francês | MEDLINE | ID: mdl-34176584

RESUMO

Allogeneic hematopoietic cell transplantation (allo-HCT), the only curative therapy for numerous hematological malignancies, carries a significant risk of morbidity and mortality. The patients and families' expectations regarding the procedure, the prognosis uncertainties, as well as the existence of potential new therapeutic possibilities, lead to frequent use of intensive care. Even though the transplant physicians are highly skilled in acute care, their knowledge of palliative approach is limited, making the use of palliative care insufficient and often late. By promoting reflection on the proportionality of care and the patients' quality of life, palliative care may contribute to the allo-HCT patients management. Nevertheless, obstacles to this approach remain. The objective of this work is to propose recommendations to promote the implementation of palliative care into transplant units.


Assuntos
Neoplasias Hematológicas/terapia , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Cuidados Paliativos , Diretivas Antecipadas , Aloenxertos , Atitude do Pessoal de Saúde , Proteínas de Bactérias , Criança , Tomada de Decisão Clínica , Deterioração Clínica , Glucosiltransferases , Pesquisas sobre Atenção à Saúde/métodos , Pesquisas sobre Atenção à Saúde/estatística & dados numéricos , Transplante de Células-Tronco Hematopoéticas/psicologia , Humanos , Comunicação Interdisciplinar , Relações Interprofissionais , Cuidados Paliativos/organização & administração , Cuidados Paliativos/psicologia , Prognóstico , Pesquisa Qualitativa , Qualidade de Vida , Sociedades Médicas , Assistência Terminal
4.
Bull Cancer ; 107(1S): S94-S103, 2020 Jan.
Artigo em Francês | MEDLINE | ID: mdl-31006487

RESUMO

Since 2010 there has been an exponential increase of the number of transplants performed from related donors. The development of haploidentical transplants increases the resort to related-donation, which presents two main advantages: a less important financial cost and a faster availability of the graft. Standards for mandatory accreditation exist, but the adherence to these recommendations is not optimal: currently, different practices regarding the organizational modalities of care, recruitment criteria, qualification and follow-up of related donors have been observed among French transplant centers. The Francophone Society of Marrow Transplant and Cellular Therapy (SFGM-TC) has developed guidelines for the consent and the non-eligibility criteria for hematopoietic stem cell donors. A multidisciplinary group has devised a booklet as a medium to inform donors about hematopoietic cell donation and transplantation in a clear and accessible language. This paper provides recommendations on post-donation follow-up, taking into account both medical standards and organizational constraints of French centers. Some tools are proposed.


Assuntos
Transplante de Células-Tronco Hematopoéticas , Doadores de Tecidos , Aloenxertos , Família , Haplótipos/genética , Histocompatibilidade , Humanos , Consentimento Livre e Esclarecido , Comunicação Interdisciplinar , Doadores Vivos , Obtenção de Tecidos e Órgãos/métodos , Obtenção de Tecidos e Órgãos/normas
5.
Bull Cancer ; 104(12S): S71-S75, 2017 Dec.
Artigo em Francês | MEDLINE | ID: mdl-29126585

RESUMO

Providing information to living donors is first and foremost a legal obligation as well as an ethical one, not to mention necessary to health care provision. It's been shown that quality of information concerning the procedure's practical aspects, scheduling of clinical tests and examinations, withdrawing stem cells for the donation, post-donation symptoms, and support provided by healthcare teams, directly impacts the donor's quality of experience. Taking this into consideration our group decided it was essential to create an informational support for donors in the form of a booklet to be provided in different hematopoietic stem cell transplant centers across France. In September 2016 in Lille, France, the Francophone Society of Bone Marrow Transplantation and Cellular Therapy (SFGM-TC) organized the 7th allergenic hematopoietic stem cell transplantation clinical practices harmonization workshops. As part of these workshops, our group worked collectively to develop a basis of indispensable information to be included in the booklet and presented using clear and accessible language.


Assuntos
Transplante de Células-Tronco Hematopoéticas , Doadores Vivos/educação , Folhetos , França , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Transplante de Células-Tronco Hematopoéticas/ética , Transplante de Células-Tronco Hematopoéticas/legislação & jurisprudência , Humanos , Sociedades Médicas
6.
Bull Cancer ; 103(11S): S273-S275, 2016 Nov.
Artigo em Francês | MEDLINE | ID: mdl-27776733

RESUMO

In an attempt to harmonize clinical practices among French hematopoietic stem cell transplantation centers, the Francophone Society of Bone Marrow Transplantation and Cellular Therapy (SFGM-TC) held its sixth annual workshop series in September 2015 in Lille. This event brought together practitioners from across the country. Our article discusses the updates and modifications for the 2016 version of the national patient follow-up care logbook.


Assuntos
Assistência ao Convalescente , Transplante de Células-Tronco Hematopoéticas/normas , Registros/normas , Adulto , Criança , França , Humanos , Sociedades Médicas , Transplante Homólogo/normas
7.
Presse Med ; 43(4 Pt 1): 460-7, 2014 Apr.
Artigo em Francês | MEDLINE | ID: mdl-24612707

RESUMO

Up to 30% of phaeochromocytomas and paragangliomas occur in the context of inherited tumor syndromes. Familial history and clinical presentation have to be strongly detailed to guide genetic testing. The identification of a genetic predisposition in a patient with phaeochromocytoma or paraganglioma has a positive impact in terms of medical care and follow-up for the proband and allows genetic testing in apparently asymptomatic family members. Two clusters of genes are described depending on their implication in the pathogenesis of inherited tumors. An algorithm for the genetic diagnosis of phaeochromocytomas and paragangliomas is proposed by The French network of oncogenetic laboratories. These recommendations will probably change with the identification of new predisposition genes and the development of new sequencing technologies.Genetic testing is prescribed by a specialist, as part of a cancer genetics specialist consultation in endocrine tumors. The psychological support is essential throughout the family survey.


Assuntos
Neoplasias das Glândulas Suprarrenais/diagnóstico , Neoplasias das Glândulas Suprarrenais/genética , Aconselhamento Genético , Paraganglioma Extrassuprarrenal/diagnóstico , Paraganglioma Extrassuprarrenal/genética , Paraganglioma/diagnóstico , Paraganglioma/genética , Feocromocitoma/diagnóstico , Feocromocitoma/genética , Algoritmos , Comportamento Cooperativo , Análise Mutacional de DNA , Árvores de Decisões , Seguimentos , Predisposição Genética para Doença/genética , Humanos , Comunicação Interdisciplinar
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