TAILIEUCHUNG - Review of Chronic Graft- Versus-Host Disease in Children After Allogeneic Stem Cell Transplantation: Nursing Perspective

Although there have been clear improvements in the delivery of specific health services, many of the systemic problems facing the . child health system seem intractable and resistant to incremental reform strategies. Both the 1981 report of the Select Panel for the Promotion of Child Health and the 1991 report of the Na- tional Commission on Children highlighted numerous system-level problems re- lated to fragmented programs, disjointed and inadequate funding streams, inade- quate performance monitoring, and the lack of a coherent planning framework. 14 These problems have not been resolved. Arguably providing some of the finest medical care in the world, the . health care system still has not. | Articles Review of Chronic Graft- Versus-Host Disease in Children After Allogeneic Stem Cell Transplantation Nursing Perspective Journal of Pediatric Oncology Nursing 28 1 6-15 2011 by Association of Pediatric Hematology Oncology Nurses Reprints and permission dOi 1043454210377177 http S SAGE Ying-Mei Liu MSN RN1 and Marilyn Hockenberry PhD RN-CS PNP FAAN1 Abstract This review presents a summary of the research literature related to the incidence and risk factors for chronic graft-versus-host disease in children following allogeneic hematopoietic stem cell transplantation. The range of incidence of chronic graft-versus-host disease in children found in this review was large from 0 to 46 . Incidence of chronic graft-versus-host disease was influenced by sample size time posttransplantation and stem cell source. Characteristics of the person eg child s age and gender and disease treatment eg sources of transplant are associated with chronic graft-versus-host disease in children after stem cell transplantation. Person and disease treatment characteristics provide a framework for understanding the factors associated with chronic graft-versus-host disease symptom experiences in children after stem cell transplantation. Timely assessment of presenting chronic graft-versus-host disease symptoms is critical for treatment and prognosis. Nursing interventions should focus on educating children and parents about the signs and symptoms of chronic graft-versus-host disease. The summary of supportive nursing care for children with chronic graft-versus-host disease provides important information to tailor effective management strategies for children with chronic graft-versus-host disease. Keywords allogeneic hematopoietic stem cell transplantation chronic graft-versus-host disease children incidence risk factors Introduction Hematopoietic stem cell transplantation HSCT has emerged as an aggressive treatment for .

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