Pros And Cons Of Stem Cell Transplantation

Stem cell Transplantation-Associated Thrombotic Microangiopathy (TA-TMA) is an awful complication with high morbidity and mortality. Patients with TA-TMA are often complicated cases. Nurse practitioners taking care of transplant patients should keep the diagnosis in mind for any patient with the new onset of thrombocytopenia, hemolytic anemia, and renal failure. Eculizumab should be a reasonable treatment approach in patients with TA-TMA after allogeneic stem cell transplantation. Awareness of the patient’s life factors can guide the advanced practice nurse to formulation of a holistic plan of care. Most importantly, the clinical decision should be tailored individually as each patient may have varied responses to therapy. On top of that, patient’s
decision is essential as there is ‘no decision about me, without me’. Patient should be given all the updated research and information gathered in order to assist in decision making. It is important that patient is informed about the potential adverse effects from both drugs, to weigh up the risks and the influence on their quality of life. As eculizumab may provide initial effectiveness, patient’s life may be prolonged though knowing there is a high rate of disease relapse but is highly dependent on the disease progression. Patient should not be denied of using eculizumab because of the cost as it could potentially be lifesaving whereby the benefits outweigh the risks of adverse effects. As an ACNP student, this author is expanding her nursing knowledge and skills into medicine (Bates, 1990). The Shuler model helps this author to see beyond the immediate objective and subjective findings. NPs intervene, based on their perception of the person’s unique wholeness, and provide throughputs that assist the person to maintain or regain health by means of comprehensive health maintenance, disease prevention, or health restoration (Shuler, 2001).