Atuação do farmacêutico residente no ambulatório de transplante de medula óssea: relato de experiência

Abstract

Hematopoietic cell transplantation (HCT) represents the treatment of choice for a large number of hematologic, neoplastic, congenital, and hereditary diseases. HCT aims to replace diseased bone marrow through the infusion procedure of CD34 stem cells, which can be from the patient himself (autologous) or from a donor (allogeneic related or unrelated) and will reconstitute healthy marrow. This study aims to describe the role of the resident pharmacist in the outpatient clinic of hematopoietic stem cell transplantation in pre and post-transplantation of patients with oncohematologic diseases, performed in a hospital in the state of Rio Grande do Sul. This is a report of experiences lived in the two phases of outpatient care: Pretransplantation - period in which the patient receives outpatient follow-up until hospitalization, with guidance on the stages of the procedure, such as their mobilization, which aims to increase the amount of stem cells for collection; the hospitalization for conditioning, which includes the administration of high doses of chemotherapy and/or total body irradiation to eradicate the underlying disease, promote immunosuppression, and create space in the marrow to receive the stem cells from the donor; the infusion of the cells and hospital discharge; and posttransplant - begins after discharge, subdivided into post-immediate, up to 100 days after the infusion of cells, and late, after that. HCT is a complex therapy whose success directly involves the performance of a multidisciplinary team with integrated work. In this scenario, the pharmacist is included, who contributes to the various stages, such as drug management, which includes knowledge of high-dose antineoplastic therapy and infectious diseases; counseling in the correct use of drugs; symptom management, and clinical follow-up for the effectiveness, quality, and safety of the transplanted patient.