NOTE (9/19/2012) – The DD Handbook was updated recently. Therefore, the page referenced in the 2009 memo (above) is now page 2-87 in the November 2010 edition of the handbook. So far in 2007, 841 HSCT procedures have been registered in the European Group for Blood and Marrow Transplantation (EBMT) database (Table 1), the rest being registered in the US International Bone Marrow Transplantation Registry (IBMTR) and in Asia.
Autoimmune diseases (ADs) are a heterogeneous group of diseases, affecting 10–12% of the population. Consensus indications for the use of HSCT to treat severe ADs were published in 1997 (1). Patients should be considered for HSCT when matching the following criteria: 1. Diagnosed with an AD severe enough to have an increased risk of mortality or advanced and irreversible disability; 2. The ADs must be unresponsive to conventional treatments; 3.
HSCT should be undertaken before irreversible organ damage so that significant clinical benefit can be achieved. The introduction of new biotherapies has modified the therapeutic panorama since 2002, resulting in a drop of activity in HSCT for inflammatory arthritis. Today, more than 1300 patients worldwide have received an HSCT for an AD alone. Autologous HSCT phase II trials showed that in patients with a favourable outcome, a resetting of a disregulated autoaggressive immune system may occur, rather than simple ablation of auto-reactive cells. Results of allogeneic HSCT are as yet unclear, due to small numbers, and heterogeneous patient groups and treatment regimens. Peripheral blood stem cells (PBSC) have mainly been used, with a the most frequent mobilisation regimen including the combination of cyclophosphamide (Cy) and G- CSF. As ADs are extremely heterogeneous, a comparison of protocols and outcome depends on careful stratification of diagnosis and phases of diseases.
![The Ebmt Handbook 2012 Revised Edition Programs The Ebmt Handbook 2012 Revised Edition Programs](https://media.springernature.com/full/nature-static/assets/v1/image-assets/bmt201270f1.jpg)
So far in 2007, 841 HSCT procedures have been registered in the European Group for Blood and Marrow Transplantation (EBMT) database ( Table 1 ), the rest being registered in the US International Bone Marrow Transplantation Registry (IBMTR) and in Asia. In the EBMT database, the most commonly transplanted diseases are mult iple sclero sis (MS), scleroder ma (SSc), rheumato id arthriti s (RA), juvenile arthritis (JIA) and systemic lupus erythematosus (SLE), coming from over 100 transplant centres in more than 20 countries ( Table 2 ). Prevalence of female sex. And young age reflects the natural distribution of the diseases.
Long-lasting respo nses were obtain ed in all disease categori es with an overall adjusted transpl ant- related mortality (TRM) being 7±3% at three years, directly related to the type of AID disease (SSc and SLE at higher risk), the year of transplant with a learning curve and the intensity of conditioning (more intensive conditioning had a higher risk of TRM but lower probability of disease progression) (2). In the following paragraphs clinical results and indications for the major ADs will be overviewed. Less common diseases have been reviewed elsewhere (3). MS is the most frequent diagnosis for which HSCT has been used. In 2006, a retrospective analysis of 183 cases from the EBMT database, of which 99 were secondary progressive forms (SP), 19 primary progressive and 41 relapsing forms (RR), was published (4). Overall, 63% of patients did not progress in their disability after a median follow-up of 42 months.
TRM was 5%, mostly concentrated prior to the year 2000. More aggressive regimens, including busulfan or a combination of graft manipulation and serotherapy, resulted in a higher toxicity without any advantage in terms of relapse prevention or disability progression. The most widely-used regimen was the association of BEAM and anti-thymocyte globulin, with an.
The ICD-9-CM Coding Handbook is the only guide published in collaboration with the Central Office on ICD-9-CM of the American Hospital Association. The Central Office is the official industry body that prepares the AHA Coding Clinic for ICD-9-CM. The Handbook helps coders understand the principles behind the classification system so they can apply the official coding advic The ICD-9-CM Coding Handbook is the only guide published in collaboration with the Central Office on ICD-9-CM of the American Hospital Association. The Central Office is the official industry body that prepares the AHA Coding Clinic for ICD-9-CM. The Handbook helps coders understand the principles behind the classification system so they can apply the official coding advice found in the ICD-9-CM Coding Manual.
Academic and in-service instructors can easily arrange course outlines and study exercises around Handbook chapters to train new and experienced coders. Each Handbook contains 100-plus exercises and review questions plus, 269 case summary exercises that are based on real patient records.