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Development of indicators and analysis of barriers for assessment and prevention of cutaneous graft-versus-host disease after haematopoietic stem cell transplantation in children
Received date: 2024-05-20
Accepted date: 2024-07-02
Online published: 2024-12-28
Supported by
Young Talent Programme in Nursing of Shanghai Jiao Tong University School of Medicine(SJTUHLXK2023)
Objective ·To gain a comprehensive understanding of the current clinical status of assessment and prevention of cutaneous graft-versus-host disease (GVHD) after haematopoietic stem cell transplantation in children, construct review indicators, analyze obstacles and facilitators in the process of conducting the study in light of clinical reality, and formulate strategies for change. Methods ·Utilizing the JBI Evidence-Based Health Care Model as a theoretical guiding framework, the clinical problem was clarified. An evidence-based practice team was established, and a systematic literature search was conducted. The evidence was then evaluated and summarized. Additionally, review indicators were constructed, and review methods were clarified in relation to the evidence. Using the Ottawa Model of Research Use, the three dimensions of evidence change, potential adopters, and practice environment were analyzed for barriers and facilitators, and corresponding strategies were developed. Results ·A total of 24 pieces of best evidence were included in the study, comprising five dimensions: skin assessment, assessment of protection, management of adverse skin reactions, medication guidance and follow-up and screening. Twenty-two review indicators were constructed on this basis, of which 14 had an implementation rate of <60% and 10 had an implementation rate of 0%; 8 had an implementation rate of >60% and 6 had an implementation rate of 100.00%. The main obstacles were the lack of relevant training and the absence of a rational management mechanism. The main facilitating factors were reliable sources of evidence and a high level of cooperation from potential stakeholders. Considering the results of the analysis of the implementation rate of the indicators under review and the obstacles, alternative measures were formulated. Conclusion ·There is a large gap between the evidence and clinical practice for the assessment and prevention of cutaneous GVHD after paediatric haematopoietic stem cell transplantation. Clinical change should be effectively implemented based on barriers and facilitators.
Liling YANG , Sha ZHAN , Xiaoyan XUE , Kai CHEN , Qing LIU , Li WANG , Yiyi WANG , Meng WU , Qunfeng LU . Development of indicators and analysis of barriers for assessment and prevention of cutaneous graft-versus-host disease after haematopoietic stem cell transplantation in children[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2024 , 44(12) : 1552 -1560 . DOI: 10.3969/j.issn.1674-8115.2024.12.008
| 1 | XU L P, WU D P, HAN M Z, et al. A review of hematopoietic cell transplantation in China: data and trends during 2008?2016[J]. Bone Marrow Transplant, 2017, 52(11): 1512-1518. |
| 2 | 李小燕, 葸瑞, 白海. 皮肤移植物抗宿主病发病机制研究进展[J]. 器官移植, 2022, 13(1): 120-125. |
| 2 | LI X Y, XI R, BAI H. Research progress on pathogenesis of skin graft-versus-host disease [J]. Organ Transplantation, 2022, 13(1): 120-125. |
| 3 | CUVELIER G D E, NEMECEK E R, WAHLSTROM J T, et al. Benefits and challenges with diagnosing chronic and late acute GVHD in children using the NIH consensus criteria[J]. Blood, 2019, 134(3): 304-316. |
| 4 | PENACK O, MARCHETTI M, RUUTU T, et al. Prophylaxis and management of graft versus host disease after stem-cell transplantation for haematological malignancies: updated consensus recommendations of the European Society for Blood and Marrow Transplantation[J]. Lancet Haematol, 2020, 7(2): e157-e167. |
| 5 | HONG J, FRAEBEL J, YANG Y, et al. Understanding and treatment of cutaneous graft-versus-host-disease[J]. Bone Marrow Transplant, 2023, 58: 1298-1313. |
| 6 | 陈亚玫, 洪秀理, 林进宗, 等. 预防性应用芦可替尼减低儿童地中海贫血非亲缘和单倍体相合造血干细胞移植后GVHD的临床观察[J]. 中国实验血液学杂志, 2022, 30(5): 1586-1589. |
| 6 | CHEN Y M, HONG X L, LIN J Z, et al. The clinical observation with ruxolitinib as graft-versus-host disease prophylaxis for children with thalassemia after unrelated or haploidentical allo-hematopoietic stem cell transplantation[J]. Journal of Experimental Hematology, 2022, 30(5): 1586-1589. |
| 7 | NANDA A, HUSAIN M A A, AL-HERZ W, et al. Chronic cutaneous graft-versus-host disease in children: a report of 14 patients from a tertiary care pediatric dermatology clinic[J]. Pediatr Dermatol, 2018, 35(3): 343-353. |
| 8 | 周小琴, 伍满群, 张诚, 等. 氧化锌联合氦氖激光照射治疗1例儿童皮肤Ⅳ度急性GVHD的护理[J]. 检验医学与临床, 2017, 14(23): 3529-3531. |
| 8 | ZHOU X Q, WU M Q, ZHANG C, et al. Nursing care of zinc oxide combined with helium-neon laser irradiation in the treatment of a case of acute GVHD of skin Ⅳ in a child [J]. Laboratory Medicine and Clinic, 2017, 14(23): 3529-3531. |
| 9 | 周英凤, 胡雁, 朱政, 等. JBI循证卫生保健模式的更新及发展[J]. 护理学杂志, 2017, 32(3): 81-83. |
| 9 | ZHOU Y F, HU Y, ZHU Z, et al. The JBI model of evidence-based healthcare:a model reconsidered[J]. Journal of Nursing Science, 2017, 32(3): 81-83. |
| 10 | 王春青, 胡雁. JBI证据预分级及证据推荐级别系统(2014版)[J]. 护士进修杂志, 2015, 30(11): 964-967. |
| 10 | WANG C Q, HU Y. JBI evidence pre-classification and evidence rank system (2014 Edition) [J]. Journal of Nurses Training, 2015, 30(11): 964-967. |
| 11 | COURIEL D, CARPENTER P A, CUTLER C, et al. Ancillary therapy and supportive care of chronic graft-versus-host disease: national institutes of health consensus development project on criteria for clinical trials in chronic graft-versus-host disease: V. Ancillary Therapy and Supportive Care Working Group report[J]. Biol Blood Marrow Transplant, 2006, 12(4): 375-396. |
| 12 | CARPENTER P A, KITKO C L, ELAD S, et al. National institutes of health consensus development project on criteria for clinical trials in chronic graft-versus-host disease: V. The 2014 Ancillary Therapy and Supportive Care Working Group report[J]. Biol Blood Marrow Transplant, 2015, 21(7): 1167-1187. |
| 13 | 杨利灵, 詹莎, 陈凯, 等. 儿童造血干细胞移植后皮肤GVHD评估与预防最佳证据总结[J]. 护理学杂志, 2023, 38(20): 39-44. |
| 13 | YANG L L, ZHAN S, CHEN K, et al. Summary of best evidence for assessment and prevention of cutaneous graft-versus-host disease after hematopoietic stem cell transplantation in children[J]. Journal of Nursing Science, 2023, 38(20): 39-44. |
| 14 | KITKO C L, PIDALA J, SCHOEMANS H M, et al. National institutes of health consensus development project on criteria for clinical trials in chronic graft-versus-host disease: Ⅱa. the 2020 clinical implementation and early diagnosis working group report[J]. Transplant Cell Ther, 2021, 27(7): 545-557. |
| 15 | ROBERT Z. Treatment of chronic graft-versus-host disease[EB/OL].(2018-02-01)[2024-10-31]. http://167.99.184.127/d/topic.htm?path=treatment-of-chronic-graft-versus-host-disease. |
| 16 | National Comprehensive Cancer Network. NCCN Guidelines for Patients?: graft-versus-host disease[EB/OL].(2021-09-31)[2024-10-31].https://www.nccn.org/patients/guidelines/content/PDF/GVDH-patient-guideline.pdf. |
| 17 | DIGNAN F L, SCARISBRICK J J, CORNISH J, et al. Organ-specific management and supportive care in chronic graft-versus-host disease[J]. Br J Haematol, 2012, 158(1): 62-78. |
| 18 | 中华医学会血液学分会造血干细胞应用学组, 中国抗癌协会血液病转化委员会. 慢性移植物抗宿主病(cGVHD)诊断与治疗中国专家共识(2021年版)[J]. 中华血液学杂志, 2021, 42(4): 265-275. |
| 18 | Hematopoietic Stem Cell Application Group, Chinese Society of Hematology, Chinese Medical Association; Hematology Translational Medicine Professional Committee, China Anti-Cancer Association. Chinese consensus on the diagnosis and management of chronic graft-versus-host disease (2021)[J]. Chinese Journal of Hematology, 2021, 42(4): 265-275. |
| 19 | ROBERT Z.Treatment of acute graft-versus-host disease[EB/OL].(2018-02-01)[2024-10-31]. http://167.99.184.127/d/topic.htm?path=treatment-of-acute-graft-versus-host-disease. |
| 20 | DIGNAN F L, CLARK A, AMROLIA P, et al. Diagnosis and management of acute graft-versus-host disease[J]. Br J Haematol, 2012, 158(1): 30-45. |
| 21 | DEPRY J L, VYAS R, LAZARUS H M, et al. Cutaneous malignant neoplasms in hematopoietic cell transplant recipients: a systematic review[J]. JAMA Dermatol, 2015, 151(7): 775-782. |
| 22 | 中华医学会血液学分会干细胞应用学组. 中国异基因造血干细胞移植治疗血液系统疾病专家共识 (Ⅲ): 急性移植物抗宿主病 (2020年版)[J]. 中华血液学杂志, 2020, 41(7): 529-536. |
| 22 | Hematopoietic Stem Cell Application Group, Chinese Society of Hematology, Chinese Medical Association. Chinese consensus of allogeneic hematopoietic stem cell transplantation for hematological disease (Ⅲ): acute graft-versus-host disease (2020)[J].Chinese Journal of Hematology, 2020, 41(7): 529-536. |
| 23 | Edward W C. Cutaneous manifestations of graft-versus-host disease (GVHD)[EB/OL].(2018-02-01)[2022-10-16].http://167.99.184. 127/d/topic.htm?path=cutaneous-manifestations-of-graft-versus-host-disease-gvhd. |
| 24 | TRAVNIK R, BECKERS M, WOLFF D, et al. Graft-versus-host disease (GvHD): an update. Part 2: prognosis and therapy of GvHD[J]. Hautarzt, 2011, 62(3): 229-237; quiz238-239. |
| 25 | JAGASIA M H, GREINIX H T, ARORA M, et al. National Institutes of Health Consensus Development Project on Criteria for Clinical Trials in Chronic Graft-versus-Host Disease: Ⅰ. The 2014 Diagnosis and Staging Working Group report[J]. Biol Blood Marrow Transplant, 2015, 21(3): 389-401.e1. |
| 26 | COURIEL D R. Ancillary and supportive care in chronic graft-versus-host disease[J]. Best Pract Res Clin Haematol, 2008, 21(2): 291-307. |
| 27 | MARKS C, STADLER M, H?USERMANN P, et al. German-Austrian-Swiss Consensus Conference on clinical practice in chronic graft-versus-host disease (GVHD): guidance for supportive therapy of chronic cutaneous and musculoskeletal GVHD[J]. Br J Dermatol, 2011, 165(1): 18-29. |
| 28 | Children's Oncology Group. Long-term follow-up guidelines for survivors of childhood, adolescent, and young adult cancers[EB/OL].(2018-10-01)[2022-10-16].http://www.survivorshipguidelines.org/. |
| 29 | CHOW E J, ANDERSON L, BAKER K S, et al. Late effects surveillance recommendations among survivors of childhood hematopoietic cell transplantation: a children's oncology group report[J]. Biol Blood Marrow Transplant, 2016, 22(5): 782-795. |
| 30 | 周英凤, 朱政, 胡雁, 等. 推动证据向临床转化(八)审查指标的构建[J]. 护士进修杂志, 2020, 35(14): 1281-1284. |
| 30 | ZHOU Y F, ZHU Z, HU Y, et al. Implementing evidence into practice: how to develop the clinical audit criteria[J]. Journal of Nurses Training, 2020, 35(14): 1281-1284. |
| 31 | 周英凤, 胡雁, 邢唯杰, 等. 推动基于证据的临床审查, 促进临床质量持续改进[J]. 中国循证医学杂志, 2020, 20(6): 621-627. |
| 31 | ZHOU Y F, HU Y, XING W J, et al. Promoting evidence-based clinical audit for continuous improvement of clinical quality[J]. Chinese Journal of Evidence-based Medicine, 2020, 20(6): 621-627. |
| 32 | MAJHAIL N S, RIZZO J D, LEE S J, et al. Recommended screening and preventive practices for long-term survivors after hematopoietic cell transplantation[J]. Bone Marrow Transplant, 2012, 47(3): 337-341. |
| 33 | HERR M M, CURTIS R E, TUCKER M A, et al. Risk factors for the development of cutaneous melanoma after allogeneic hematopoietic cell transplantation[J]. J Am Acad Dermatol, 2020, 83(3): 762-772. |
| 34 | LI E B, SONG J S, HUANG J T, et al. Sun exposure and protection practices in children after allogeneic hematopoietic stem cell transplantation: a survey-based cross-sectional cohort study[J]. Pediatr Dermatol, 2019, 36(6): 882-886. |
| 35 | ARMENIAN S H, LINDENFELD L, IUKURIDZE A, et al. Technology-enabled activation of skin cancer screening for hematopoietic cell transplantation survivors and their primary care providers (TEACH)[J]. BMC Cancer, 2020, 20(1): 721. |
| 36 | 张晓菊, 胡雁, 周英凤, 等. 推动证据向临床转化(九)证据临床转化过程中的障碍因素分析[J]. 护士进修杂志, 2020, 35(15): 1382-1386. |
| 36 | ZHANG X J, HU Y, ZHOU Y F, et al. Facilitating knowledge translation and evidence implementation: how to analyze the barriers of evidence implementation[J]. Journal of Nurses Training, 2020, 35(15): 1382-1386. |
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