- Browse by Subject
Browsing by Subject "bone marrow transplantation"
Now showing 1 - 3 of 3
Results Per Page
Sort Options
Item The Caregiver’s Role Across the Bone Marrow Transplantation Trajectory(Wolters, 2015) Von Ah, Diane; Spath, Mary; Nielsen, Adele; Fife, Betsy; School of NursingBackground: Approximately 50 000 people undergo bone marrow transplants (BMTs) each year worldwide. With the move to more outpatient and home care, family caregivers are playing an ever-increasing role. However, there is little information regarding the needs and well-being of caregivers of individuals undergoing BMT. Objective: The study purpose was to gain a better understanding of the BMT experience across the trajectory from the perspective of the family caregiver. Methods: Qualitative interviews were conducted with 15 family caregivers during and 4 months after BMT. Interviews were recorded, transcribed verbatim, and analyzed using a content analysis approach. Results: Uncertainty and need for more information were 2 major underlying themes noted across the early BMT trajectory. Caregivers reported feeling overwhelmed and juggling multiple roles, including (a) ‘‘interpreter,’’ which included obtaining and translating medical information to their partner, family, and social network; (b) ‘‘organizer,’’ which included arranging and coordinating medical appointments (pre- and post-BMT) for the patient, but also juggling the needs of immediate and extended family members; and (c) ‘‘clinician,’’ which included assessing and identifying changes in their significant other, with many reporting that they had to be ‘‘vigilant’’ about or ‘‘on top of’’ any changes. Caregivers also reported the most challenging aspects of their role were to ‘‘be strong for everyone’’ and ‘‘finding balance.’’ Conclusions: Our results underscore the unique needs of family caregivers as a consequence of BMT. Implications for Practice: A greater understanding of the adaptation of caregivers will lead to the development of effective interventions for families going through BMT.Item Leptin Receptor, a Surface Marker for a Subset of Highly Engrafting Long-Term Functional Hematopoietic Stem Cells(2021-04) Trinh, Thao Le Phuong; Broxmeyer, Hal E.; Srour, Edward F.; Kapur, Reuben; Utpal, DaveThe entire hematopoietic system rests upon a group of very rare cells called hematopoietic stem cells (HSCs). Due to this extraordinarily crucial role, after birth HSCs are localized to the deep bone marrow niche, a hypoxic environment inside the bone where HSCs are under well-orchestrated regulation by both cellular and humoral factors. Among the cellular components regulating hematopoiesis are Leptin Receptor (LEPR)-expressing mesenchymal/stromal cells and adipocytes; both have been demonstrated to have significant influence on the maintenance of HSCs under homeostasis and in stress-related conditions. It has been reported in early work by others that HSCs and hematopoietic progenitor cells (HPCs) express LEPR. However, whether LEPR+ HSCs/HPCs are functionally different from other HSCs/HPCs was unknown. In this study, I demonstrated for the first time that murine LEPR+ Lineage-Sca-1+cKit+ (LSK, a heterogenous population consisting of HSCs/HPCs) cells even though constituting a small portion of total LSK cells are significantly enriched for both phenotypic and functional self-renewing long-term (LT) HSCs as shown in primary and secondary transplants in lethally irradiated recipients. LEPR+LSK cells are also more enriched for colony-forming progenitor cells assessed by colony-forming unit (CFU) assays. In addition, LEPR+ HSCs (defined as LSKCD150+CD48-) exhibited robust repopulating potential as compared to LEPR-HSCs in long-term competitive transplantation assays. To elucidate the molecular pathways that may govern functional properties of LEPR+HSCs, bulk RNA-seq on freshly sorted cells was done. Gene set enrichment analyses (GSEA) revealed Interferon Type I and Interferon γ (IFNγ) Pathways were significantly enriched in LEPR+HSCs while mitochondrial membrane protein gene set was significantly enriched in LEPR-HSCs. Interestingly, proinflammatory signaling including IFNγ pathway has been suggested to be critical for the emergence of embryonic HSCs from the hemogenic endothelium. Altogether, our work demonstrated that LEPR+HSCs represent a small subset of highly engrafting adult BM HSCs. These results may have potential therapeutic implications in the field of hematopoietic transplantation as LEPR is highly conserved between mice and humans.Item Outcome of domino hematopoietic stem cell transplantation in human subjects: An international case series(Elsevier, 2018) Belderbos, Mirjam E.; Gennery, Andrew R.; Dvorak, Christopher C.; Blok, Henric-Jan; Eikema, Dirk-Jan; Silva, Juliana M. F.; Veys, Paul; Neven, Bénédicte; Buckley, Rebecca; Cole, Theresa; Cowan, Morton J.; Goebel, W. Scott; Hoenig, Manfred; Kuo, Caroline Y.; Stiehm, E. Richard; Wynn, Robert; Bierings, Marc; Pediatrics, School of Medicine