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Acute radiation injury in man has been amply reviewed in the past decades (1-8). Information for those reviews was mainly derived from the Hiroshima and Nagasaki experience (3), from radiation accidents as a con sequence of testing nuclear weapons and the application of nuclear energy (9-13) and from the intentional irradiation of patients, mostly for the treatment of malignancies and/or as conditioning for transplantation (14-20). Further, a large body of data derived from animal experimentation has led to cautious extrapolations to the human situation (14). An elaborate review dealing with early somatic effects of radiation in a man was published by UNSCEAR ) in 1962 (2). It was supplemented in 1969 with a similar document dealing mostly with radiation-induced chromosome aberra tions, the effects of radiation on the nervous system and, radio-active contamination of the environment by nuclear testing (21). In a more recent UNSCEAR report (1972) the main topics were genetic effects, carcinogenesis and effects of radiation on the immune response (22). The early effects of radiation in man were also expertly and comprehensively reviewed in a report by the United States National Research Council in 1967 (23).
This book, written by a team of international experts, concisely reviews the rationale and clinical application of image-guided total marrow irradiation, a rapidly emerging area in radiation oncology and hematopoietic cell transplantation. The aim is to provide the practicing radiation oncologist, hematologist, medical physicist, and bone marrow transplant researcher with a fundamental understanding of key aspects and an appreciation of the increasing significance of total marrow irradiation as conditioning for bone marrow transplantation. Detailed attention is paid to the impacts of recent advances in radiation therapy technology, functional PET and MRI, and understanding of the response of bone marrow to radiation. Full consideration is also given to the ways in which technological advances in image-guided radiation therapy have created new opportunities to treat bone marrow transplant patients with limited transplant options due to advanced disease, age, or co-morbidities. Further topics covered include the ways in which cancer stem cells and the marrow microenvironment influence response to radiation therapy and the implementation of new-generation predictive radiobiologic factors in the clinic.
This book is open access under a CC BY 4.0 license. This textbook, endorsed by the European Society for Blood and Marrow Transplantation (EBMT), provides adult and paediatric nurses with a full and informative guide covering all aspects of transplant nursing, from basic principles to advanced concepts. It takes the reader on a journey through the history of transplant nursing, including essential and progressive elements to help nurses improve their knowledge and benefit the patient experience, as well as a comprehensive introduction to research and auditing methods. This new volume specifically intended for nurses, complements the ESH-EBMT reference title, a popular educational resource originally developed in 2003 for physicians to accompany an annual training course also serving as an educational tool in its own right. This title is designed to develop the knowledge of nurses in transplantation. It is the first book of its kind specifically targeted at nurses in this specialist field and acknowledges the valuable contribution that nursing makes in this area. This volume presents information that is essential for the education of nurses new to transplantation, while also offering a valuable resource for more experienced nurses who wish to update their knowledge.
Blood and Marrow Transplantation Long Term Management Hematopoietic cell transplantation (HCT) provides curative therapy for a variety of diseases. Over the past several decades, significant advances have been made in the field of HCT, to the point where HCT has become an integral part of treatment modality for a variety of hematologic malignancies and some nonmalignant diseases. HCT remains an important treatment option for a wide variety of hematologic and nonhematologic disorders, despite recent advances in the field of immunologic therapies. Factors driving this growth include expanded disease indications, greater donor options (expanding unrelated donor registries and haploidentical HCT), and accommodation of older and less fit recipients. The development of less toxic pretransplant conditioning regimens, more effective prophylaxis of graft-versus-host disease (GVHD), improved infection control, and other advances in transplant technology have resulted in a rapidly growing number of transplant recipients surviving long-term free of the disease for which they were transplanted. The changes over decades in the transplant recipient population and in the practice of HCT will have almost inevitably altered the composition of the long-term survivor population over time. Apart from an increasingly older transplant recipient cohort, the pattern of transplant indications has shifted from the 1990s when chronic myeloid leukemia made up a significant proportion of allo-HCT indications. Changes in cell source, donor types, conditioning regimens, GVHD prophylaxis, and supportive care have all occurred, with ongoing reductions in both relapse and non-relapse mortality (NRM) have been demonstrated. These patients have increased risks for a variety of late complications, which can cause morbidity and mortality. Most long-term survivors return to the care of their local hematologists/oncologists or primary care physicians, who may not be familiar with specialized monitoring and management of long complications after HCT for this patient population. As HCT survivorship increases, the focus of care has shifted to the identification and treatment of long-term complications that may affect quality of life and long-term morbidity and mortality. Preventive care as well as early detection and treatments are important aspects to reducing morbidity and mortality in long-term survivors after allo-HCT. This second edition, Blood and Marrow Transplantation Long Term Management: Survivorship after Transplant, provides up-to-date information about diagnosis, screening, treatment, and long-term surveillance of long-term survivors after HCT.
Bone Marrow transplantation or Hematopoietic stem cell transplantation is a life saving procedure in a number of diseases,hematological and non hematological, which fail alternative medical management or have no other treatment options. It has transformed the lives of thousands of patients and their families around the world battling with fatal or debilitating diseases.There are many unique aspects of bone marrow transplantation which makes it very different from solid organ transplants. There is an enormous amount of research going on in this field both at clinical and basic science levels.With the rapidly changing world and field of transplantation, there is a need for an authoritative and up to date resource for transplant professionals. This book titled Contemporary Bone Marrow Transplantation aims to be a reference text comprehensively covering various facets of hematopoietic stem cell transplants with latest insights about the technique and basic science behind it . The book is the product of collective effort of transplant professionals round the world, and will reflect their experience as well as the current standard of care practices in Stem cell transplantation.The book will be divided into different sections focusing on the basic science of bone marrow transplant, the technical aspects of the procedure itself and the supportive care of transplant patients.There will also be a section each on epidemiology, upcoming trends and also case studies , which will discuss real case scenarios from the experience of the authors, to illustrate the practical challenges in managing bone marrow transplant recipients.