Hematopoietic stem cell transplantation as an approach for student reflection on integrality in health

Authors

DOI:

https://doi.org/10.22421/1517-7130/es.2021v22.e781

Keywords:

Medical education, Bone marrow transplantation, Social determinants of health

Abstract

The integrality that is expected from health care must be built since undergraduate studies. This study aims at associating the overall survival rate with sociodemographic conditions in a sample of patients undergoing hematopoietic stem cell transplantation, providing the medical student with yet another way of approaching the social determinants of the health and disease process. This is an exploratory-descriptive, retrospective study with a quantitative approach based on the analysis of medical records. Fisher's exact test, Pearson chi-square, multivariate logistic regression, and survival analysis (Kaplan-Meier curves), considering a minimum significance level of 5% and a minimum test power of 90%. One-hundred three procedures were performed and 22.2% of the patients died, with a decrease in survival up to 21 months. Students were able to analyze various social realities and adequate housing conditions were those that allowed a longer survival time without influencing the overall survival rate.

Author Biographies

Maria Cristina Silva Montenegro Corrêa, Faculdades Pequeno Princípe

Médica

Ana Paula Zampieri Lago, Faculdades Pequeno Príncipe

Graduanda de Medicina. Faculdades Pequeno Príncipe, Curitiba, Paraná, Brasil

Carolina Silva Pedrollo, Faculdades Pequeno Príncipe

Graduanda de Medicina. Faculdades Pequeno Príncipe, Curitiba, Paraná, Brasil

Euripides Ferreira, Hospital Pequeno Príncipe

Médico. Hospital Pequeno Príncipe, Curitiba, Paraná, Brasil

References

APACN [Internet]. Associação Paranaense de Atenção à Criança com Neoplasia. [cited 2020 Jun 02]. Available from: http://apacn.com.br

Bejanyan N, Brunstein CG, Cao Q, Lazaryan A, Ustun C, Warlick ED, et al. Predictive value of disease risk comorbidity index for overall survival after allogeneic hematopoietic transplantation. Blood Advs. 2019;3(3):230-6.

Casate JC, Corrêa AK. A humanização do cuidado na formação dos profissionais de saúde nos cursos de graduação. Rev Esc Enferm USP. 2012;46(1):219-26.

Castagna A, Mcmonagle L, Eeltink C, Liptrott S. Transplantation through the generations. In: Kenyon M, Babic A, editors. The european blood and marrow transplantation textbook for nurses. New York: Springer International Publishing; 2018. p. 135-61.

Castro Jr, CG de, Gregianin LJ, Brunetto AL. Transplante de medula óssea e transplante de sangue de cordão umbilical em pediatria. J Pediatr. 2001;77(5):345-60.

Chang J, Hsiao M, Blodget E, Akhtari M. Increased risk of 100-day and 1-year infection-related mortality and complications in haploidentical stem cell transplantation. J Blood Med. 2019 May;10:135-43.

Fernandes J F, Nichele S, Daudt L, Tavares, R B, Seber, A, Kerbauy, F R et al. Transplantation of hematopoietic stem cells for primary immunodeficiencies in Brazil: challenges in treating rare diseases in developing countries. J Clin Immunol. 2018 Nov;38(8):917-26.

Finotti ACF, Silva CR, Bariani C, Silva AMTC, Silva CC da, Cruz AD da. Epidemiologia do transplante de medula óssea no Hospital Araújo Jorge de 2000 a 2004 em Goiânia, Goiás, Brasil. Estud Biol. 2006;28(65):77-85.

Gokgoz Z, Arslan O. Haploidentical stem cell transplantation: T cell depleted and repleted. Transfus Apher Sci. 2018 Apr;57(2):171-3.

Gonzáles AD, Almeida MJ. Integralidade da saúde: norteando mudanças na graduação dos novos profissionais. Cien Saude Colet. 2010;15(3):757-62.

Hierlmeier S, Eyrich M, Wölfl M, Schlegel PG, Wiegering V. Early and late complications following hematopoietic stem cell transplantation in pediatric patients – a retrospective analysis over 11 years. PLoS One. 2018 Oct;13(10):e0204914.

Janicksák H, Masszi, T, Reményi P, Ungvari GS, Gazdag G. Quality of life and its socio-demographic and psychological determinants after bone marrow transplantation. Eur J Haematol. 2013;91(2):135-40.

Johnston E E, Bogetz J, Saynina O, Chamberlain L J, Bhatia S, Sanders L. Disparities in inpatient intensity of end-of-life care for complex chronic conditions. Pediatrics. 2019 May;143(5):e20182228.

Marotti M. Quais são os objetivos clínicos que determinam a eficácia dos tratamentos em oncologia? Rev Assoc Med Bras. 2007;53(6):477-8.

Mennin S. Introduction: sustainability of PBL and innovation in medical education at Maastricht University. Lessons from Problem-Based Learning. 2010 Aug DOI: 10.1093/acprof:oso/9780199583447.003.0001.

Ministério da Educação (Brasil). Resolução nº. 3, de 20 de junho de 2014. Diretrizes Curriculares Nacionais do Curso de Graduação em Medicina. Diário Oficial da União 23 jun 2014;Seção 1.

Patel SS, Rybicki LA, Corrigan D, Bolwell B, Dean R, Liu H, et al. Prognostic factors for mortality among day +100 survivors after allogeneic hematopoietic cell transplantation. Biol Blood Marrow Transplant. 2018 May;24(5):1029-34.

Pidala, J, Anasetti, C, Jim, H. Health-related quality of life following haematopoietic cell transplantation: patient education, evaluation and intervention. Br J Haematol. 2010 Feb;148(3):373-385.

Polomeni A, Rio B. Greffe de moelle osseuse: prendre soin du donneur. Hématologie. 2011;17(1):93-8.

Silla L, Fischer GB, Paz A, Daudt LE, Mitto I, Katz B, et al. Patient socioeconomic status as a prognostic factor for allo-SCT. Bone Marrow Transplant. 2009 Apr;43(7):571-7.

Styczýnski J, Tridello G, Koster L, Iacobelli S, van Biezen A, van der Werf S, et al. Death after hematopoietic stem cell transplantation: changes over calendar year time, infections and associated factors. Bone Marrow Transplant. 2020 Jan; 55(1):126-36.

Tanzi EM. Health-related quality of life of hematopoietic stem cell transplant childhood survivors. J Pediatr Oncol Nurs. 2011 Jul-Aug;28(4):191-202.

Thakar MS, Broglie L, Logan B, Artz A, Bunin N, Burroughs LM, et al. The hematopoietic cell transplant comorbidity index predicts survival after allogeneic transplant for nonmalignant diseases. Blood. 2019;133(7):754-62.

Published

2021-10-13

How to Cite

1.
Silva Montenegro Corrêa MC, Lago APZ, Pedrollo CS, Ferreira E. Hematopoietic stem cell transplantation as an approach for student reflection on integrality in health. Espac. Saude [Internet]. 2021 Oct. 13 [cited 2024 May 16];22. Available from: https://espacoparasaude.fpp.edu.br/index.php/espacosaude/article/view/781

Issue

Section

Artigos