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THE BRAZILIAN SOCIETY FOR BLOOD AND MARROW TRANSPLANTATION (SBTMO) PRESENTS THE BRAZILIAN GUIDELINES ON HEMATOPOIETIC STEM CELL TRANSPLANTATION

THE BRAZILIAN SOCIETY FOR BLOOD AND MARROW TRANSPLANTATION (SBTMO) PRESENTS THE BRAZILIAN GUIDELINES ON HEMATOPOIETIC STEM CELL TRANSPLANTATION

This is an observational and cross-sectional study, carried out in May 2020, targeting adult individuals of both sexes who are members of multiprofessional teams working in Brazilian HSCT units in the current period of the pandemic by completing and analyzing a questionnaire. pre-formulated. HSCT units that cannot access the questionnaire were excluded from the study. The analysis of the operation profile of HSCT units in Brazil, through the application of a pre-structured questionnaire, is not an accurate tool, since it assumes some premises that may prove to be wrong, especially in this current scenario in Brazil. However, the data reveal the vulnerability of patients with onco-hematological diseases to infection by COVID-19, especially during HSCT procedures, in relation to the general population. Despite its limitations, it can be valuable to plan policies.

Introduction: Microvascular endothelial damage is a well-recognized complication of bone marrow transplantation (BMT) and the mechanisms of this disorder are still poorly under­stood. The objective of this scenario is to evaluate the relationship between inflammatory markers and other factors that influence platelet consumption and platelet transfusion yield, as well as the presence of embolic and / or vascular thrombotic events in patients submitted to high-dose chemotherapy conditioning for Bone marrow transplant. Material and Methods: Prospective analysis of patients, including 25 patients who under­went autologous and allogenic BMT. The patients were evaluated in relation to previous radiotherapy, CD34 + cell count, period of neutropenia, body mass index (BMI), ferritin, re­active C protein (RCP), relating these factors to the number of platelet transfusions, plate­let refractoriness and vascular events such as sinusoidal obstruction syndrome (SOS) and bone marrow grafting syndrome. Results: Only BMI> 25 Kg / m2 of the studied variables presented a statistically significant value (p = 0.003) in relation to the lower need for transfusion of platelet concentrate. For platelet refractoriness and / or vascular events none of the variables was statistically sig­nificant. The conditions found in the 3 cases of platelet refractoriness and in the 2 cases of vascular events have characteristics like those described in the literature. Conclusion: Although the cause is unclear, we agree with data reported in the literature that patients with high BMI have a lower need for transfusion of platelets. Small sampling limits our comparisons and significant statistical inference; however, we cannot rule out the relevance of a descriptive analysis of the results, especially if we consider that each patient should be evaluated in an individualized way in clinical practice.

Patients with multiple myeloma (MM) in clinical con­ditions to be referred to autologous hematopoietic stem cell transplantation (AHSCT) generally start therapy with an induction chemotherapy followed by high-dose alkylating and AHSCT. The ideal regimen and the number of pre-AHSCT induction is still a controversial subject, however, opting for at least three to four cycles of chemotherapy including a drug with immunomodulatory action, a protea­some inhibitor, with a corticosteroid, are advised as the first line before AHSCT.