Hematopoietic stem cell transplantation ((HSCT)) is considered a potentially curative treatment for several malignant and non-malignant hematologic disorders including transfusion-dependent thalassemia (TDT). However, (HSCT) is associated with short-term and long-term complications. One of the recognized causes of morbidity and mortality in TDT patients is heart-related complications. Additionally, cardiac involvement is likely to be more common in patients who proceed to (HSCT). So the risks of cardiac complications should be carefully weighed against the advantages of the primary disease cure. This review aims to discuss the cardiac considerations that should be kept in mind in TDT patients going through the path of (HSCT).

Mycosis fungoides (MF) is the most common subtype of cutaneous T-cell lymphoma (CTCL) and is characterized by a heterogeneous clinical course and variant stage involvement. Indolent disease is usually observed in its early stages. However, the treatment options for patients with advanced MF are limited and have poor outcomes. Allogeneic Hematopoietic stem cell transplantation (allo-(HSCT)) is a potential curative treatment for refractory cases. Here, we describe the case of a 34-year-old man who was diagnosed with MF at an advanced stage. Eight months before allo-(HSCT), the patient received six courses of polychemotherapy based on cyclophosphamide, doxorubicin, vincristine, and prednisolone, which were administered every three weeks. A partial response was obtained. He underwent allo-(HSCT) after a myeloablative conditioning regimen and remained in complete remission (CR) for 26 months posttransplantation. Our findings confirm that allo-(HSCT) can be a curative option for refractory MF.

Background: The level of adherence to drug therapy after allogeneic Hematopoietic stem-cell transplantation (Allo-(HSCT)) can affect the patient’, s outcome, and poor adherence is one of the factors in first-year mortality after (HSCT). Material and Methods: This study assessed adherence to cyclosporine and prednisolone as the immunosuppressant regimen in 110 post-(HSCT) patients (> 18 years). Demographic characteristics, clinical information, and cyclosporine levels were obtained. A validated Persian medication adherence scale was used to assess adherence to cyclosporine and prednisolone. Results: For 110 patients, the calculated mean of the total score of cyclosporine and prednisolone was 7. 73 ±,0. 62 and 7. 63 ±,0. 73, respectively. Poor adherence to medication in this population was 27. 7% and 22. 7% to prednisolone and cyclosporine, respectively. A significant correlation was observed between adherence total score and cyclosporine levels at the third-and fourth-month post-transplant (r = 0. 52, P < 0. 001 and r = 0. 60, P = 0. 001). In the first, second, and third months, the mean of cyclosporine levels in the high adherence level was higher than the moderate and poor adherence levels. Additionally, there was an association between adherence score and the level of cyclosporine. One score increase in adherence scale on average increased cyclosporine level by 34. 48 ng/ml. Conclusion: In this study, medication non-adherence was high, which indicates the need for more careful monitoring of post-(HSCT) patients’,medication use. This is even more crucial currently since it has been confirmed that adherence can affect cyclosporine levels as the most effective immunosuppressant agent in preventing graft-versus-host disease (GVHD).

Background: Pulmonary complications are important enough to notice in Hematopoietic stem cell transplantation ((HSCT)). The patients undergoing (HSCT) might have infectious and non-infectious problems associated with morbidity and mortality. The pulmonary complications of (HSCT) are well-recognized in adults; however, studies on children are limited, especially in Iran. This study was done to evaluate the infectious and non-infectious pulmonary complications and the corresponding factors in children who underwent (HSCT). Materials and Methods: This retrospective cohort study included the patients who underwent (HSCT) in Mofid Children’s Hospital in Tehran, Iran, during the years 2015 -2021. Overall, 144 medical files were evaluated, out of which 128 had undergone (HSCT). The extracted data were about underlying diseases, age at transplant, sex,  type of (HSCT), donor type, cell source, conditioning regimen, graft versus host disease (GVHD) prophylaxis, infectious and non-infectious pulmonary complications, and associated factors. The data analysis was done by the SPSS software version 26. Chi-square, Fisher exact test and regression were also used for the analysis. Results: Infectious and non-infectious pulmonary complications were reported in 26 people (20.3%) and 11 people (8.6%), respectively. Positive coronavirus disease 2019 (COVID-19) PCR was detected only in two patients. Infectious complications were significantly lower in patients with neuroblastoma compared to other underlying diseases (2.7% vs. 27.5%, P = 0.002). These complications were significantly more frequent among those with other (HSCT) complications compared to those without such complications (34.6% vs. 16.7%, P=0.042). Non-infectious pulmonary complications were significantly higher in boys (13.5%) than in girls (1.9%) (P = 0.024). Conclusion: Due to the high rate of pulmonary infections in bone marrow transplant patients, clear differential diagnosis and diagnostic work are essential.

Background: Hematopoietic stem cell transplantation strongly affects the care of patients suffering from malignant hematologic disorders and the implementation of interventions such as continuous care can affect the outcomes of treatment in a positive way. The aim of the current study was to determine the effect of implementing a continuous care model on self-care behavior in patients receiving (HSCT) between 2019 and 2020 in Shariati Hospital affiliated to Tehran University of Medical Sciences. Materials and Methods: This semi-experimental study was conducted on 48 patients who were considered as candidates for (HSCT) at the Hematology, Oncology and stem cell Transplant Research Center, Shariati Hospital. Participants for the present study were selected by the continuous care model based on the inclusion criteria. A 4-stage continuous care model (CCM) developed was used as an intervention in the study. A valid and reliable assessment questionnaire designed to measure the self-care behaviors of the patient (PHLP2) was used for the collection of demographic information. It was completed in the first and fourth stages of implementing the continuous care model. Data were analyzed using SPSS 22 software (Chicago, IL, USA). Moreover, the Chi-square test, pair t-test, and independent samples t-test were used in this study. Results: There was no statistically significant difference between the intervention and control group in terms of demographic variables (p>0. 05). Prior to intervention, no statistically significant difference was observed in the mean self-care score among (HSCT) patients in the intervention and control group (p=0. 590), while, after the intervention, a statistically significant difference was observed in the mean self-care score among (HSCT) patients in the intervention and control group (p<0. 001). Conclusion: The study concluded that due to the increase in the number of patients undergoing (HSCT) across the country in recent years as well as the ease of implementation and low cost of this strategy to promote the self-care of (HSCT) recipients, relevant authorities ought to do it with the proper planning and policy nationwide. According to the results of the study, the use of a continuous care model on self-care behavior in patients receiving (HSCT) is recommended.