The role of high-dose chemotherapy supported by hematopoietic stem cell transplantation in patients with multiple myeloma: implications for nursing.
Multiple myeloma (MM), a neoplastic proliferation of plasma cells originating from the B-cell line, is associated with deleterious complications and poor outcomes. The failure of conventional combination chemotherapies to improve the overall survival of patients with MM has led to the use of high-dose chemotherapy supported by stem cell transplantation (SCT). Although several novel therapies have emerged since the late 1990s, their survival benefits are undetermined. High-dose chemotherapy with SCT provides better response rates compared to conventional chemotherapy and yields a trend toward greater survival benefits, especially with the use of a tandem (two successive) transplantation strategy. This article discusses standard SCT in patients with MM and some of the new transplantation strategies, including tandem autologous SCTs and reduced-intensity nonmyeloablative allogeneic SCT, and their implications for nursing.
Rodriguez
Anna Liza
AL
Hematopoietic Stem Cell Tranplantation Inpatient Unit, Northwestern Memorial Hospital, Chicago, IL, USA. anrodrig@nmh.org
Tariman
Joseph D
JD
Enecio
Toreend
T
Estrella
Stella Marie
SM
D017677:Age Distribution; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D001781:Blood Component Removal / Q000379:methods; D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy; D015925:Cryopreservation / Q000379:methods; D016903:Drug Monitoring; D019650:Hematopoietic Stem Cell Mobilization / Q000379:methods; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects / Q000379:methods* / Q000451:nursing; D006801:Humans; D008875:Middle Aged; D009101:Multiple Myeloma / Q000401:mortality / Q000628:therapy*; D024802:Nurse's Role; D009730:Nursing Assessment; D009859:Oncology Nursing / Q000458:organization & administration*; D011785:Quality Assurance, Health Care; D017751:Safety Management; D015996:Survival Rate; D014182:Transplantation, Autologous / Q000379:methods; D014184:Transplantation, Homologous / Q000379:methods; D016896:Treatment Outcome