3. Introduction
Chemotherapy (antineoplastic therapy) is the use of
chemicals as a systemic therapy for cancer. In the 1970s
chemotherapy was established as an effective treatment
modality for cancer. Chemotherapy can offer cure for some
cancers, control other cancers for long periods, and in
some instances offer palliative relief of symptoms.
PRESENTATION TITLE 3
4. Primary goal
is to eliminate or reduce the number of cancer
cells in the primary tumor and metastatic tumor
site(s).
5. Goals
Cure
Burkitt's lymphoma
Wilms' tumor
Neuroblastoma
Acute lymphocytic
leukemia
Hodgkin's
lymphoma
Testicular cancer
Control
• Breast cancer
• Non-Hodgkin's
lymphoma
• Small cell lung
cancer
• Ovarian cancer
Palliation
• Relieve pain
• Relieve
obstruction
• Improve the
sense of well-
being
PRESENTATION TITLE 5
7. • 1. Alkylating agents:
• Alters DNA structure by misreading DNA code, initiating breaks
in the DNA molecule, cross-linking DNA strands,
• e.g. cyclophosphamide.
• 2. Nitrosoureas:
• Similar to the alkylating agents.
• They can cross the blood-brain barrier
• e.g.streptozocin.
Drugs…. 7
8. • 3.Topoisomerase I inhibitors:
• Induce breaks in the DNA strand by binding to enzyme
topoisomerase I,preventing cells from dividing,
• e.g. etoposide.
• 4. Antimetabolites:
• Antimetabolites interfere with the biosynthesis of metabolites or
nucleic acids necessary for RNA and DNA synthesis.
• e.g. methotrexate.
Drugs……. 8
9. • 5. Antitumor antibiotics:
• Interfere with DNA synthesis by binding DNA and prevent RNA
synthesis.
• e.g.Bleomycin.
• 6. Mitotic spindle poisons:
• Arrest metaphase by inhibiting mitotic tubular formation and
inhibitingDNA and protein synthesis,
• e.g. paclitaxel and vinblastine.
PRESENTATION TITLE 9
10. • 7.Hormonal agents:
• Hormonal agents bind to hormone receptor sites that alter
cellular growth, blocks binding of estrogens to receptor site,
inhibit RNA synthesis.
• e.g. tamoxifen.
• 8. Miscellaneous-Procarbazine
Drugs…. 10
11. Principles….
1. treating patient with number of different drugs
simultaneously.
2. a. Primary induction:
• patients with advanced cancer for which notreatment exists.
• b. Adjuvant chemotherapy:
• It is used when tumor burden is at minimum.
• It is also called as post-operative chemotherapy
11
12. Principles…..
• c.Neoadjuvant chemotherapy
• Preoperative chemotherapy
• Designed to shrink the primary tumor
• 3.Toxicities of therapy should not overlap
• 4.Mechanisms of excretion should not be same
• 5.Routs of administration may be…..
• 6.Drug interaction should be clear
PRESENTATION TITLE 12
13. • 7.Chemotherapy works by impairing mitosis
• 8. Tumors with high growth fraction are more sensitive to
chemotherapy
• 9. Drug affects more differeciated tumor more effectively.
• 10.Palliative chemotherapy given to decrease tumor load and
increase life expectancy.
PRESENTATION TITLE 13
24. extravassation
• Extravasation
• • Inadvertent administration of a vesicant solution into
surrounding tissue – Vesicant is a fluid or medication that causes
the formation of blisters, with subsequent sloughing of tissues
occurring from the tissue necrosis
PRESENTATION TITLE 24
25. Clinical manifestations
• Signs and Symptoms
• – Complaints of pain or burning –
• Swelling proximal to or distal to the IV site
• – Puffiness of the dependent part of the limb
• – Skin tightness at the venipuncture site
• – Blanching and coolness of the skin
PRESENTATION TITLE 25
26. 26
This Photo by Unknown Author is licensed under CC BY-SA-NC
This Photo by Unknown Author is licensed under CC BY-SA
27. • Within days browny discoloration, indurations, dry
desquamation, blistering with discomfort and/or pain.
• Full thickness skin necrosis that involves underlying tendons and
neurovascular structures that leads to permanent damage.
PRESENTATION TITLE 27
28. management
• Stop infusion at once
• • Withdraw drug
• • Leave cannula insitu
• • Elevate limb to reduce oedema
• • Apply hot/cold pack
• • Subsequent management depends upon drug involved and
degree of damage.
PRESENTATION TITLE 28
29. • Preventing Complications
• • Ensure staff are trained and supervised
• • Supervised practice and competence assessed
• • Practice continually updated
• • Ensure correct preparation of patient, equipment and
environment
• • Aseptic non touch technique •
PRESENTATION TITLE 29
30. • Documentation .
• Documentation should be done at the time of extravasation
and every 4hrs until resolution of extravasation has occurred.
• • Date and time
• • Type and gauge of venous access device
• • Number and location of venepuncture attempts
• • Name of the drug administered
• • Drug sequence
PRESENTATION TITLE 30
32. introduction
• Radiation therapy is the use of ionizing radiation in the treatment of
disease.
• It damages the genes (DNA) and some of the molecules of a cell.
Radiation damages the genes of a cancer cell so that it cannot grow
and divide any more.
• It is primary, adjuant,or palliative.
PRESENTATION TITLE 32
33. goals
Cure or shrink early
stages of cancer
PRESENTATION TITLE
Stop reoccurrence in
another area
Eg Lung cancer
Treat sumptoms of
advanced cancer
Eg pain, breathing
difficulty, trouble
wallowing
33
34. Radiation is energy that is carried by waves or a stream of
particles. It damages the genes (DNA) and some of the
molecules of a cell. Genes control how cells grow and
divide. Radiation damages the genes of a cancer cell so
that it cannot grow and divide any more. This means
radiation can be used to kill cancer cells and shrink tumors.
PRINCIPLE
PRESENTATION TITLE 34
35. TREATMENT PLANNING
• 1. To plan the treatment, physician will take the following
considerations into account:
• a. Type of cancer.
• b. The position of the tumor.
• c. The size .
• d. Whether it is close to structures that are sensitive to
radiation.
• e. How far the radiation needs to travel into the body.
• f. General health and medical history of the patient.
PRESENTATION TITLE 35
36. • 2. Define the goal of therapy whether it may be curative or
palliative.
• 3. Determine the session needed for the patient. It depends on
the size and position of the tumor.
• 4. Before to plan the treatment session, nurse or radiographer
will ask the patient to sign a consent form.
PRESENTATION TITLE 36
37. • 5. The radiotherapy planning makes sure that the cancer gets
the prescribed dose of radiation while normal body tissues get
as little as possible.
• a. The area of the body exposed to radiation is called the
radiotherapy field.
• b. Some normal tissue immediately around the tumor exposed
to the same dose but the physician's aim is to keep this as low as
possible to reduce the risk of side effect.
• . It is necessary to put marks on the skin to outline the treatment
field. These marks are in the form of very small tattoos, which
are dots, the size of pinpoint made by using ink.
PRESENTATION TITLE 37
38. Types of radiation
• 1….Steriostatic radio surgery [SRS]
• SBRT
• Non surgical and non invasive method for delivering high dose
radiation
PRESENTATION TITLE 38
39. • 2. 3D CONFORMAL RADIATION THERAPY[3D CRT]
• Based on imaging studies
• External radiation from multiple angles
• Patient is in immobilizing devices
PRESENTATION TITLE 39
40. • INTENSITY MODULATED RADIATION THERAPY[IMRT]
• Deliver radiations of different intensity to different part of
tumor
• V-MAT
• HIGH DOSE/LOW DOSE BRACHY THERAPY
• Surgically placing radio active material near tumor eg prostate
cancer
• INTENSITY MODULATED PROTON THERAPY
• Radiation using external radiation
PRESENTATION TITLE 40
42. Safety standards
• 1.Distance
• 2.time- limited to 30 min
• 3.Shielding
• Patient should be provided with private room ,if he has sealed
internal radio active substances
PRESENTATION TITLE 42
43.
44. Adverse effects
• Skin- erythema, desquamation, permanent darkening
1. Avoid sun exposure
2. No lotion or topical medications until treatment complete
3. Do not remove markings
PRESENTATION TITLE 44
46. Nurses responsibilities for sealed implants
• Provide Private room with bathroom
• Radioactive material sign should be placed outside
• Wear dosimeter
• No pregnant staff
• Visitors limited to 30 mins per day
• Visitors are restricted and must remain at 6 feet
distance
• All dressings & linens saved until implant removed
•
PRESENTATION TITLE 46
47. • lead container & long handled forceps,
• lead gloves kept in room in event of dislodgement
•
PRESENTATION TITLE 47
48. For unsealed
• Presents potential contamination hazard
• All articles in room are considered contaminated.
• After discharge, articles are discarded but taken to
protected Rubber gloves worn with direct care
• No pregnant staff
• Articles in room: phone, call light, floors covered with
plastic. Disposable plastic /paper should be used for
dietary trays & utensils.
• Flush toilet used by patient several times.
• Keep linen & gowns kept in separate isolation bags
PRESENTATION TITLE 48
49. Loss of Radioactive Material
• Considered an emergency.
• Search should initiated by radiation staff.
• Removes nothing from the room while patient has
radioactive material in place.
• If radioactive material is found, use long handled
forceps & gloves.
• Notify Atomic Energy Center.
PRESENTATION TITLE 49
50.
51. goals.
• Diagnose cancer (diagnostic surgery or biopsy)
• Remove a tumor or a portion of the cancer (curative or
debulking surgery)
• Determine where the cancer is located, whether it has spread
and whether it is affecting the functions of other organs (staging
surgery)
• Remove body tissue that may become cancerous (preventive
surgery)
PRESENTATION TITLE 51
52. • Support other types of treatment, such as installing an infusion
port (supportive surgery)
• Restore the body's appearance or function (reconstructive
surgery)
• Relieve side effects (palliative surgery
PRESENTATION TITLE 52
53. Surgical chemo
• Hyperthermic intraperitoneal chemotherapy (HIPEC) surgery is a two-
step procedure that treats certain cancers in the abdomen.
• Cancerous tumors are surgically removed[CYTOREDUCTIVE], and then
heated chemotherapy drugs are applied directly inside the abdomen
to eliminate the remaining cancerous cells.
PRESENTATION TITLE 53
54. Mainly used in……
• Adrenal cancer
• Appendix cancer
• Colon and rectal cancer
• Gastric (stomach) cancer
• Liver cancer
• Mesothelioma
• Ovarian cancer
• Pancreatic cancer
• Peritoneal cancer
PRESENTATION TITLE 54
55. Less invasive surgeries
• cryosurgery
• A procedure in which an extremely cold liquid or an
instrument called a cryoprobe is used to freeze and destroy
abnormal tissue.
PRESENTATION TITLE 55
56. • To cure internal tumors, a hollow instrument called a cryoprobe
is used, which is placed in contact with the tumor. Liquid
nitrogen or argon gas is passed through the cryoprobe.
• Ultrasound or MRI is used to guide the cryoprobe and monitor
the freezing of the cells.
• This helps in limiting damage to adjacent healthy tissues.
• A ball of ice crystals forms around the probe which results in
freezing of nearby cells.
56
57. • When it is required to deliver gas to various parts of the tumor,
more than one probe is used.
• After cryosurgery, the frozen tissue is either naturally absorbed
by the body in the case of internal tumors, or it dissolves and
forms a scab for external tumor.
PRESENTATION TITLE 57
58.
59. Laser surgery
• Uses beam light energy to remove small cancers without
surrounding tissue damage
• The primary uses of lasers in soft tissue surgery are to cut,
ablate, vaporize, and coagulate.
• Types……..
• Carbon dioxide (CO2)
• Argon
• Neodymium
PRESENTATION TITLE 59
60. Treating cancer with lasers
• To shrink or destroy a tumor with heat
• To used in a type of surgery called photoablation or photocoagulation
to destroy tissues or seal tissues or blood vessels. This type of surgery
is often used to relieve symptoms, such as when large tumors block
the windpipe (trachea) or swallowing tube (esophagus), causing
problems breathing or eating.
60
61. Electro surgery
• application of a high-frequency (radio frequency) alternating
polarity, electrical current to biological tissue as a means to cut,
coagulate, desiccate, or fulgurate[RFA] tissue.
• Its benefits include the ability to make precise cuts with limited
blood loss. In electrosurgical procedures, the tissue is heated by
an electric current.
PRESENTATION TITLE 61
62. • Although electrical devices that create a heated probe may be
used for the cauterization by using electrocautery
• Electrocautery uses heat conduction from a probe heated to a
high temperature by a direct electrical current (much in the
manner of a soldering iron).
PRESENTATION TITLE 62
65. • Mohs micrographic surgery is also called microscopically
controlled surgery.
• It’s used to remove certain skin cancers by shaving off one very
thin layer at a time. After each layer is removed, the doctor looks
at the tissue with a microscope to check for cancer cells. This
procedure is repeated until all the cells in a layer look normal.
• Eg..skin cancer
PRESENTATION TITLE 65
67. • making small holes and using special long, thin
instruments, the laparoscope can also be used to
remove some tumors. This can help reduce blood loss
during surgery and pain afterward. It can also shorten
hospital stays and allow people to heal faster.
• colon, rectum, liver, prostate, uterus, and kidney cancers
are treated by using laparoscopic method.
PRESENTATION TITLE 67
69. • Tissue samples of any areas of concern on the lining of the chest
wall can be taken out, fluid can be drained, and small tumors on
the surface of the lung can be removed.
• Thoracoscopy is a procedure a doctor uses to look at
the space inside the chest (outside of the lungs). This is
done with a thoracoscope, a thin, flexible tube with a
light and a small video camera on the end. The tube is
put in through a small cut made near the lower end of
the shoulder blade between the ribs..
PRESENTATION TITLE 69
71. • Robotic surgery
• Robotic surgery is a type of laparoscopic (or thoracoscopic)
surgery where the doctor uses precise robotic arms to control
some of the surgical instruments. :
• it can help reduce blood loss during surgery and pain afterward.
It can also shorten hospital stays and let people to heal faster.
• Robotic surgery is sometimes used to treat cancers of the colon,
prostate, and uterus.
PRESENTATION TITLE 71
72. • Getting Ready for and Recovering from Cancer Surgery
PRESENTATION TITLE 72
73. Pre operative preparation
1. Informed consent
2. Clarify the doubts regarding surgery and explain about
reconstruction and prosthesis available and their use.
3. Instruct the patient regarding the cessation of tobacco, alcohol and
smoking.
4. Ask the patient to stop blood thinners, anti inflammatory pain
medications.
5. keep patient in nill by mouth status
6. Skin preparation and bowel preparation
PRESENTATION TITLE 73
74. PRE OP TESTING
• BLOOD CHECK-BLOOD COUNT, SUGAR, LFT AND RFT AND RISK
OF BLEEDING
• URINE TEST
• CHEST X RAY
• ECG
• OTHER SCANS AND TESTS
PRESENTATION TITLE 74
75. Post op care
• Care of tubes ,catheters and drains
• Maintain fluid and electrolyte status
• Monitoring of vital signs frequently, observe for shock ,collapse
or hemorrhage.
• Maintain semi fowlers position and elevate arm up to 30 degree
incase of mastectomy.
• Dressing should be done under aseptic method.
• Provide early ambulation, Instruct for breathing and coughing
exercise
PRESENTATION TITLE 75
77. • Therapy which involves manipulating or boosting our
immune system and create an environment that is not
conductive for immune cells to grow or attack cancer
cells directly.
PRESENTATION TITLE 77
78. TYPES
• Checkpoint inhibitors:
• An immune checkpoint is a protein that can stop the body’s
immune system from responding to cancer cells. These proteins
include PD-1, PD-L1, and CTLA-4.
• Immune checkpoint inhibitors work by targeting and blocking
these proteins, which then allows the immune system to find
and attack cancer cells.
PRESENTATION TITLE 78
79. • Chimeric antigen receptor (CAR) T-cell therapy:
• This therapy takes some T-cells from a patient's blood, mixes
them with a special virus that makes the T-cells learn how to
attach to tumor cells, and then gives the cells back to the patient
so they can find, attach to, and kill the cancer.
• Cytokines: This treatment uses cytokines (small proteins that
carry messages between cells) to stimulate the immune cells to
attack cancer.
• Immunomodulators: This group of drugs generally boosts parts
of the immune system to treat certain types of cancer.
PRESENTATION TITLE 79
80. • Cancer vaccines:
• Vaccines are substances put into the body to start an immune
response against certain diseases.
• Monoclonal antibodies (mAbs or MoAbs): These are man-made
versions of immune system proteins. mAbs can be very useful in
treating cancer because they can be designed to attack a very specific
part of a cancer cell.
• Oncolytic viruses: This treatment uses viruses that have been
modified in a lab to infect and kill certain tumor cells.
PRESENTATION TITLE 80
81. SIDE EFFECTS
SIDE EFFECTS
swelling and
weight gain
heart palpitations
sinus congestion
diarrhea
infection
organ inflammation
FLUE LIKE
SYMPTOMS
SEVERE
HYPERSENSITIVITY
REACTION
PRESENTATION TITLE 81
83. • Types
1. Small molecule drugs:
These are the drugs can enter the targets that are inside the cell.
2. Monoclonal antibodies:[therapeutic antibodies]
These are the proteins that are produced in the lab and designed to
attach to specific targets found on cancer cells.
These will directly stop cancer cells from growing or cause them to self
destruct.
PRESENTATION TITLE 83
84. Some drugs…
Bladder cancer
avelumab
Brain cancer
belzutifan
Breast cancer
letrozole
cervical
bevacizumab
Endocrine and
neuroendocrine
Lobenguane l
131
endometrial
Lenvatinib
mesylate
leukemia
dasatinib
Kidney cancer
nivolumab
PRESENTATION TITLE 84
85. What can we expect
Pills or capsules
Monoclonal antibodies are
given through iv
PRESENTATION TITLE
Every day ,week or months
Or in cyclers
How it given How often
Physical exam
Blood test
X rays
scans
What to do in between
85
86. Side effects
• Problem with blood clotting and wound healing
• High bp
• Fatigue
• Mouth sores
• Nail changes
• Skin problems [rash or dry skin]
PRESENTATION TITLE 86
87. Therapy which includes application of hormones to block the effects
of certain hormones which can cause cancer cell growth .
PRESENTATION TITLE 87
HORMONE THERAPY
88. • Breast cancer
• Prostate cancer
• Thyroid cancer
• Adrenal cancer
• Neuroendocrine tumor
• Pituitary gland tumor
• Uterine cancer
PRESENTATION TITLE 88
89. Methods of delivering
Oral hormone therapy
Injected hormone therapy
Surgical ablation: bilateral orchiectomy for prostate cancer
Ovarian ablation for breast cancer
PRESENTATION TITLE 89
90. Side effects of hormone therapy:
Sexual health concern: low sex drive, problems in reaching orgasm,
erectile dysfunction.
Vaginal and menstruation changes: vaginal dryness, discharge,
itching or irritation, vaginal bleeding
Hot flashes and night sweats:
Weight changes:
Bone health risk: osteoporosis
Mood changes
Fatigue, gi symptoms
Cognitive changes
PRESENTATION TITLE 90
91. STEM CELL AND BMT
PRESENTATION TITLE 91
This Photo by Unknown Author is licensed under CC BY
92. HEMOPOETIC STEM CELL TRANSPLAANTATION
TRANSPLANTATION OF HEMOPOETIC STEMCELLS USUALLY DELIVERED
FROM BONEMARROW, PEREPHERAL BLOOD OR UMBILICAL CORD BLOOD.
BMT: THE COLLECTION OF MARROW CELLS EITHER FROM
PATIENT OR DONOR AND SUBSEQUENT ADMINISTRATION OF
THESE CELLS FOR THE THERAPEUTIC PURPOSE.
PRESENTATION TITLE 92
93. TYPES
• FROM THE PATIENT
• ADMINISTERED
FOLLOWING OTHER
FORMS OF TREATMENT
PRESENTATION TITLE
• TISSUE HARVESTING
FROM A COMPATIBLE
PERSONS USUALLY
SIBLINGS
AUTOLOGOUS ALLOGENIC
• HARVESTING FROM
IDENTICAL TWINS
• LOGICALLY IDENTICAL TO
PATIENTS MARROW
SYNGENIC
93
96. HISTOCOMPATIBILITY TESTING.
• Human leukocyte antigen (HLA) testing is also called HLA typing or
tissue typing. It is a blood test that identifies antigens
• on the surface of cells and tissues. It is used to match a transplant
recipient (person receiving a transplant) with a compatible donor
(person who gives their cells for a transplant).
PRESENTATION TITLE 96
97. SOURCES
AUTOLOGOUS
Removed from the recipient during the remission phase…
It eliminates the risk of gvtd and graft rejection
ALLOGENIC
Obtained from the relative or non relative who has identical HLA type
Most common type but highest rate of mortality and morbidity due to GVHD
SYNGENEIC
Donated by an identical twin
Perfect HLA match and eliminate the risk of marrow rejection
PRESENTATION TITLE 97
98. Preparation of the donor
• Ensure mental and physical wellbeing of the donor
• Histocompatibility testing
• Medical history and physical examination
• Chest x ray,eeg
• Cbc,vira,syphyllis, l testing for hiv
• ABO and Rh, coagulation studies
• Informed written consent
PRESENTATION TITLE 98
99. Bonemarrow collection
• After GA OR SA marrow is obtained from the anterior iliac crest or
sternum.
• 400 -800 ml of marrow is obtained
• The blood is placed in the heparinized tissue culture media and
filtered for fat and removal of bone particles
• Marrow can be infused immediately or preserve in solution
containing dimethyl sulfoxide.
PRESENTATION TITLE 99
100. Prepare recepient
• Perform physical and psychological examination
• Additional investigations may be required to stage the existing
disease accurately.
• The recipient must receive immune ablative therapy before
transplant.
• A small catheter is inserted to provide suitable access for marrow
infusion as well as for antibiotics, blood products, hyperalimentation
and frequent blood sampling.
• Initiate total body irradiation and administer very high doses of single
chemotherapeutic agent or fractionated doses of multiple agents.
PRESENTATION TITLE 100
101. Bone Marrow Infusion
1. The infusion of the marrow is often anticlimactic after the recipient
has undergone the rigorous preparatory chemotherapy and radiation
therapy.
2. The marrow is usually administered immediately after the
conditioning regiment is complete.
3. A large blood infusion bag equipped with standard blood filter is
used for the administration of bone emboli.
PRESENTATION TITLE 101
102. 4. Small volume may also be prefiltered and given by IV push by a
physician.
5. Potential immediate adverse reactions are allergic(For example,
urticaria, chills, fever), volume overload and pulmonary complications
secondary to fat emboli.
6. The period immediately after transplant is critical.
7. Localized skin involvement can be resolved without treatment
whereas systematic complications may be treated with
immunosuppressive drug therapy.
PRESENTATION TITLE 102
103. Nursing management
• Nursing assessment include nutritional assessments, physical
examinations, organ function tests, psychological aspects, assessing
past antigen exposure and the patient's support system.
• Explain the procedure to patient and family. Discuss about the risk
and benefits, and then take written consent.
• Monitor patients WBC count frequently
• Restrict the visitor's entry. isolation for several weeks.
PRESENTATION TITLE 103
104. • Monitor intake and output.
• Check vital signs.
• Fluids to be administered for maintaining balance.
PRESENTATION TITLE 104
105. PRESENTATION TITLE 105
• During Procedure
• Establish I/V line/central line.
• Administer prescribed dose of epinephrine and diphenhydramine to
manage adverse reaction.
• After transfusion, check the vital signs:
a. Every 15 min x1 hr
b. Every 30 min × 2 hr
c. Every 60 min × 5 hr
• Closely monitor patient for adverse reactions.
• Maintain and follow strict aseptic technique.
• Administer prescribed medicines, blood components.
106. • Provide psychological support.
• Enhance the patient and family's coping.
• Providing post-transplantation care: Ongoing assessments
in follow-up visits are essential to detect late effects of
therapy after BMT, which occur 100 days or more
after the procedure, and donors also require nursing
care through being assisted in maintaining realistic
expectations of themselves as well as of the patient.
PRESENTATION TITLE 106
107. complication
• Nausea vomiting diarrhea
• Mucositis and pain
• Thrombocytopenia and anemia
• Bacterial infection
• Fluid overload
• Veno -occlusive disease:a condition in which the blood flow to the
liver is partially or completely obstructed.
• Respiratory distress
• Organ damage
• relapse
PRESENTATION TITLE 107
108. PRESENTATION TITLE 108
• GVHD occurs when the donor's immune system reacts against the
recipient's tissue. The new cells recognize the tissues and organs of the
recipient's body as foreign. The most common sites for GVHD are the
skin, gastrointestinal tract, liver and lungs.
• GVHD can develop suddenly (acute) or over a period of time (chronic)..
Skin rash, diarrhea, nausea, abdominal pain and abnormal liver function
tests are some of the manifestations of acute GVHD.
• A number of measures are taken prior to transplant to reduce the risk of
this complication. If GVHD becomes a significant medical problem,
medications such as steroids and cyclosporine are commonly utilized for
its treatment.
109. • GRAFT FAILURE
the infused bone marrow or blood stem cells fail to take over the role
of producing blood cells for the host's body. This potential complication
is called graft failure.
It may occur as a result of infection, recurrent disease or if the stem cell
count of the donated marrow was insufficient to cause engraftment.
Graft failure may be treated with another transplant, which would
include a conditioning regimen and an infusion of bone marrow or
blood stem cells, or it may be treated by giving a second infusion
without using a conditioning regimen. In either case, the infused stem
cells may be from a different donor and/or from a different source (i.e.,
from bone marrow instead of cord blood) than was used for the first
infusion.
PRESENTATION TITLE 109
