Hematopoietic stem cell transplantation-associated thrombotic microangiopathy and the role of advanced practice providers and pharmacists
Hematopoietic stem cell transplantation-associated thrombotic microangiopathy (HSCT-TMA) is a severe and potentially life-threatening complication. HSCT-TMA is often underdiagnosed due to multifactorial pathophysiology and a historic lack of standard diagnostic criteria. Identification of the multi-...
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Veröffentlicht in: | Bone marrow transplantation (Basingstoke) 2023-06, Vol.58 (6), p.625-634 |
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description | Hematopoietic stem cell transplantation-associated thrombotic microangiopathy (HSCT-TMA) is a severe and potentially life-threatening complication. HSCT-TMA is often underdiagnosed due to multifactorial pathophysiology and a historic lack of standard diagnostic criteria. Identification of the multi-hit hypothesis and the key role of the complement system, particularly the lectin pathway of complement, has led to development of treatments targeting the underlying pathogenesis of HSCT-TMA. Additional research is ongoing to investigate the efficacy and safety of these targeted therapies in patients with HSCT-TMA. Advanced practice providers (APPs; nurse practitioners and physician assistants) and pharmacists are critical members of the multidisciplinary HSCT team and ensure management of patients throughout the continuum of care. Additionally, pharmacists and APPs can improve patient care through medication management of complex regimens; transplant education for patients, staff, and trainees; evidence-based protocol and clinical guideline development; assessment and reporting of transplant-related outcomes; and quality improvement initiatives to improve outcomes. Understanding the presentation, prognosis, pathophysiology, and treatment options for HSCT-TMA can improve each of these efforts.
Collaborative practice model for monitoring and care of HSCT-TMA. Advanced practice providers and pharmacists contribute to many aspects of patient care in transplant centers, including medication management for complex regimens; transplant education for patients, staff, and trainees; evidence-based protocol and clinical guideline development; assessment and reporting of transplant-related outcomes; and quality improvement initiatives. HSCT-TMA is a severe and potentially life-threatening complication that is often underdiagnosed. The collaboration of a multidisciplinary team of advanced practice providers, pharmacists, and physicians can optimize recognition, diagnosis, management, and monitoring of patients with HSCT-TMA, thereby improving outcomes for these patients. |
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Collaborative practice model for monitoring and care of HSCT-TMA. Advanced practice providers and pharmacists contribute to many aspects of patient care in transplant centers, including medication management for complex regimens; transplant education for patients, staff, and trainees; evidence-based protocol and clinical guideline development; assessment and reporting of transplant-related outcomes; and quality improvement initiatives. HSCT-TMA is a severe and potentially life-threatening complication that is often underdiagnosed. The collaboration of a multidisciplinary team of advanced practice providers, pharmacists, and physicians can optimize recognition, diagnosis, management, and monitoring of patients with HSCT-TMA, thereby improving outcomes for these patients.</description><identifier>ISSN: 0268-3369</identifier><identifier>EISSN: 1476-5365</identifier><identifier>DOI: 10.1038/s41409-023-01951-3</identifier><identifier>PMID: 37059738</identifier><language>eng</language><publisher>London: Nature Publishing Group UK</publisher><subject>692/699/1541 ; 692/700/139 ; 692/700/565 ; Cell Biology ; Complement system ; Hematology ; Hematopoietic Stem Cell Transplantation - adverse effects ; Hematopoietic stem cells ; Humans ; Internal Medicine ; Longitudinal Studies ; Medicine ; Medicine & Public Health ; Pathogenesis ; Pathophysiology ; Patients ; Pharmacists ; Prognosis ; Public Health ; Quality control ; Review ; Review Article ; Stem cell transplantation ; Stem Cells ; Thrombotic Microangiopathies - diagnosis ; Thrombotic Microangiopathies - etiology ; Thrombotic Microangiopathies - therapy ; Thrombotic microangiopathy ; Transplantation</subject><ispartof>Bone marrow transplantation (Basingstoke), 2023-06, Vol.58 (6), p.625-634</ispartof><rights>The Author(s) 2023</rights><rights>2023. The Author(s).</rights><rights>The Author(s) 2023. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c475t-a0bb8320354c69ddf8ee00eb6661bab6cb88081a921da9e768cf5fe843d6cced3</citedby><cites>FETCH-LOGICAL-c475t-a0bb8320354c69ddf8ee00eb6661bab6cb88081a921da9e768cf5fe843d6cced3</cites><orcidid>0000-0002-3168-2521</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37059738$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mahmoudjafari, Zahra</creatorcontrib><creatorcontrib>Alencar, Maritza C.</creatorcontrib><creatorcontrib>Alexander, Maurice D.</creatorcontrib><creatorcontrib>Johnson, Darren J.</creatorcontrib><creatorcontrib>Yeh, Jason</creatorcontrib><creatorcontrib>Evans, Misty D.</creatorcontrib><title>Hematopoietic stem cell transplantation-associated thrombotic microangiopathy and the role of advanced practice providers and pharmacists</title><title>Bone marrow transplantation (Basingstoke)</title><addtitle>Bone Marrow Transplant</addtitle><addtitle>Bone Marrow Transplant</addtitle><description>Hematopoietic stem cell transplantation-associated thrombotic microangiopathy (HSCT-TMA) is a severe and potentially life-threatening complication. HSCT-TMA is often underdiagnosed due to multifactorial pathophysiology and a historic lack of standard diagnostic criteria. Identification of the multi-hit hypothesis and the key role of the complement system, particularly the lectin pathway of complement, has led to development of treatments targeting the underlying pathogenesis of HSCT-TMA. Additional research is ongoing to investigate the efficacy and safety of these targeted therapies in patients with HSCT-TMA. Advanced practice providers (APPs; nurse practitioners and physician assistants) and pharmacists are critical members of the multidisciplinary HSCT team and ensure management of patients throughout the continuum of care. Additionally, pharmacists and APPs can improve patient care through medication management of complex regimens; transplant education for patients, staff, and trainees; evidence-based protocol and clinical guideline development; assessment and reporting of transplant-related outcomes; and quality improvement initiatives to improve outcomes. Understanding the presentation, prognosis, pathophysiology, and treatment options for HSCT-TMA can improve each of these efforts.
Collaborative practice model for monitoring and care of HSCT-TMA. Advanced practice providers and pharmacists contribute to many aspects of patient care in transplant centers, including medication management for complex regimens; transplant education for patients, staff, and trainees; evidence-based protocol and clinical guideline development; assessment and reporting of transplant-related outcomes; and quality improvement initiatives. HSCT-TMA is a severe and potentially life-threatening complication that is often underdiagnosed. The collaboration of a multidisciplinary team of advanced practice providers, pharmacists, and physicians can optimize recognition, diagnosis, management, and monitoring of patients with HSCT-TMA, thereby improving outcomes for these patients.</description><subject>692/699/1541</subject><subject>692/700/139</subject><subject>692/700/565</subject><subject>Cell Biology</subject><subject>Complement system</subject><subject>Hematology</subject><subject>Hematopoietic Stem Cell Transplantation - adverse effects</subject><subject>Hematopoietic stem cells</subject><subject>Humans</subject><subject>Internal Medicine</subject><subject>Longitudinal Studies</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Pathogenesis</subject><subject>Pathophysiology</subject><subject>Patients</subject><subject>Pharmacists</subject><subject>Prognosis</subject><subject>Public Health</subject><subject>Quality control</subject><subject>Review</subject><subject>Review Article</subject><subject>Stem cell transplantation</subject><subject>Stem Cells</subject><subject>Thrombotic Microangiopathies - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Bone marrow transplantation (Basingstoke)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mahmoudjafari, Zahra</au><au>Alencar, Maritza C.</au><au>Alexander, Maurice D.</au><au>Johnson, Darren J.</au><au>Yeh, Jason</au><au>Evans, Misty D.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Hematopoietic stem cell transplantation-associated thrombotic microangiopathy and the role of advanced practice providers and pharmacists</atitle><jtitle>Bone marrow transplantation (Basingstoke)</jtitle><stitle>Bone Marrow Transplant</stitle><addtitle>Bone Marrow Transplant</addtitle><date>2023-06-01</date><risdate>2023</risdate><volume>58</volume><issue>6</issue><spage>625</spage><epage>634</epage><pages>625-634</pages><issn>0268-3369</issn><eissn>1476-5365</eissn><abstract>Hematopoietic stem cell transplantation-associated thrombotic microangiopathy (HSCT-TMA) is a severe and potentially life-threatening complication. HSCT-TMA is often underdiagnosed due to multifactorial pathophysiology and a historic lack of standard diagnostic criteria. Identification of the multi-hit hypothesis and the key role of the complement system, particularly the lectin pathway of complement, has led to development of treatments targeting the underlying pathogenesis of HSCT-TMA. Additional research is ongoing to investigate the efficacy and safety of these targeted therapies in patients with HSCT-TMA. Advanced practice providers (APPs; nurse practitioners and physician assistants) and pharmacists are critical members of the multidisciplinary HSCT team and ensure management of patients throughout the continuum of care. Additionally, pharmacists and APPs can improve patient care through medication management of complex regimens; transplant education for patients, staff, and trainees; evidence-based protocol and clinical guideline development; assessment and reporting of transplant-related outcomes; and quality improvement initiatives to improve outcomes. Understanding the presentation, prognosis, pathophysiology, and treatment options for HSCT-TMA can improve each of these efforts.
Collaborative practice model for monitoring and care of HSCT-TMA. Advanced practice providers and pharmacists contribute to many aspects of patient care in transplant centers, including medication management for complex regimens; transplant education for patients, staff, and trainees; evidence-based protocol and clinical guideline development; assessment and reporting of transplant-related outcomes; and quality improvement initiatives. HSCT-TMA is a severe and potentially life-threatening complication that is often underdiagnosed. The collaboration of a multidisciplinary team of advanced practice providers, pharmacists, and physicians can optimize recognition, diagnosis, management, and monitoring of patients with HSCT-TMA, thereby improving outcomes for these patients.</abstract><cop>London</cop><pub>Nature Publishing Group UK</pub><pmid>37059738</pmid><doi>10.1038/s41409-023-01951-3</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0002-3168-2521</orcidid><oa>free_for_read</oa></addata></record> |
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subjects | 692/699/1541 692/700/139 692/700/565 Cell Biology Complement system Hematology Hematopoietic Stem Cell Transplantation - adverse effects Hematopoietic stem cells Humans Internal Medicine Longitudinal Studies Medicine Medicine & Public Health Pathogenesis Pathophysiology Patients Pharmacists Prognosis Public Health Quality control Review Review Article Stem cell transplantation Stem Cells Thrombotic Microangiopathies - diagnosis Thrombotic Microangiopathies - etiology Thrombotic Microangiopathies - therapy Thrombotic microangiopathy Transplantation |
title | Hematopoietic stem cell transplantation-associated thrombotic microangiopathy and the role of advanced practice providers and pharmacists |
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