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首页> 外文期刊>Journal of geriatric oncology >Frailty and stem cell transplantation in the older patient with cancer
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Frailty and stem cell transplantation in the older patient with cancer

机译：老年癌症患者的脆弱和干细胞移植

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Age, performance status, and single organ comorbidities have been typically used to assess the suitability of patients for stem cell transplantation (SCT). Until recently, these criteria, combined with poor outcomes, have excluded many older patients from SCT. Improvements in supportive care, reduced-intensity conditioning regimens, and more tolerable graft-versus-host disease (GVHD) prophylaxis have increased the number of older individuals now considered to be viable candidates for SCT. However, this raises concerns about the tolerability of SCT for older persons. Many SCT recipients present with fatigue, weakness, dyspnea, sleep disturbance, and anorexia in the post transplant period, symptoms consistent with a frailty syndrome. These observations, plus the fact that SCT is increasingly offered to older patients, suggest the need to use assessment tools that are appropriate for this population and able to assess frailty. Comprehensive geriatric assessment (CGA) needs to be tailored specifically to the SCT patient. CGA may prove useful in identifying and risk stratifying those older SCT recipients most likely to become frail following transplantation. Such insight would allow the early use of pharmacologic and rehabilitative interventions that could be targeted to help minimize the toxicity associated with SCT. Frailty caused by SCT may also provide a model of accelerated frailty due to aging, as many similarities may exist in the two syndromes.
机译：年龄，行为状态和单器官合并症通常已用于评估患者是否适合干细胞移植（SCT）。直到最近，这些标准加上不良的预后，将许多老年患者排除在SCT之外。支持治疗的改善，降低强度的调节方案以及更可忍受的移植物抗宿主病（GVHD）预防措施的增加，增加了现在被认为是SCT可行候选人的老年人的数量。然而，这引起了对老年人的SCT耐受性的担忧。许多SCT接受者在移植后出现疲劳，虚弱，呼吸困难，睡眠障碍和厌食症，症状与体弱综合症一致。这些观察结果以及向年龄更大的患者提供SCT的事实表明，有必要使用适合该人群并能够评估体弱的评估工具。需要针对SCT患者量身定制全面的老年医学评估（CGA）。 CGA可能对识别那些最可能在移植后变得脆弱的老年SCT接受者并对其进行风险分层方面很有用。这样的洞察力将有助于及早使用药物和康复干预措施，以最大程度地减少与SCT相关的毒性。 SCT导致的虚弱还可能提供因衰老而加速虚弱的模型，因为这两种综合症可能存在许多相似之处。

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