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Report of the Nurses Group 14th International Study Day & 6th Research Study Day - 6-7 October 2022 - Brussels

Nurses Group
Nursing Research Committee
Nursing Scientific Committee

14th International Study Day

Summary report written by Marijke Quaghebeur, a member of the EBMT NG Scientific Committee

The 14th international Study Day and 6th Research day from the EBMT nurses group took place 6th and 7th of October in Brussels (Belgium), for the first time live again after virtual years due to COVID!

The International Study Day was organised by the international EBMT nurses’ group together with the EBMT group. Mrs Michelle Kenyon, president of the EBMT nursing group, gave a warm introduction to more than 88 nurses and allied health care members from 21 different countries.

The morning agenda started with the session on donor challenges, brought by Sophie Van Lancker, stem cell transplant coordinator from the paediatric clinic at the University Hospital Gent (Belgium).  It became an interactive session with a discussion of the audience. Regulation for family donors, protection of the donor and potential conflicts of interest were discussed during this interesting session.

The second presentation was by Dr. Ann De Becker, head of clinic and transplant physician at the University hospital of Brussels.  Treatment of infectious diseases after allogenic stem cell transplantations remains a huge challenge.  As valued members of the HSCT team, nurses play a key role in the early detection and management of infections. Although the raising antimicrobial resistance (AMR) remains a global health and development threat, also in stem cell transplant patients.  

Followed by a session on Fecal microbiota transplantation in the treatment of GVHD Dr. Anke Vanderlinden, transplant physician at the University Hospital in Antwerp, gave us an interesting literature overview about this treatment. She started with an update on the theoretical background of our microbiota system and the impact of an allogenic stem cell transplantation on this specific topic.  Although faecal microbiota transplantation is not standard therapy in the treatment of GVHD, further randomised research is needed to gain more insight & evidence on this interesting topic.

Nutrition guidelines and practical tips in post-stem cell transplantation patients were clarified by Christel Kuppers, a dietician at the Jessa Hospital Hasselt in Belgium. She took us with her along the short and long-term follow-up and nutritional needs after an HSCT. A practical tool such as the tasting box could be a helpful instrument to coach post-stem cell transplant patients in their taste experience and to gain back their nutritional energy.       

Dr. Saskia Bos, a respiratory consultant from Newcastle University and Freeman Hospital (UK) gave an overview of pulmonary cGVHD.  Early recognition of cGVHD requires routine screening of asymptomatic patients to detect a decline in lung function. Screening should ideally be implemented in all allo-HSCT recipients. Here the threshold for referral to a specialised transplant team is set at FEV1 decline ≥ 10% from the patient’s baseline or Day 100 assessment.  Nurses have to be aware of this pulmonary cGVHD screening.  

Kathy Goris is CNS in HPCT at the University Hospitals Leuven (Belgium) and chair of the Scientific Committee Nurses Group EBMT. She explained in her presentation that several advances in HCT techniques and supportive care measures have led to improvements in early transplant mortality and long-term survival for HCT recipients, but that the relative mortality rates continue to remain higher than in the general population and that late effects contribute significantly to long-term morbidity and mortality. She gave an overview of the late effects after HPCT with the important impact of cGVHD, but especially wanted to highlight the important role that nurses play in the early recognition and prevention of cGVHD.

The Therakos symposium at noon time was about facilitating the ECP journey via effective communication. A typical ECP day in the University Hospital Saint-Luc: this interactive presentation was given by Alessia Pelino, an apheresis nurse from the University hospital Saint–Luc in Brussels.  Together with Jorn Dehli Krisiansens, of the Oslo University Hospital (Norway), they shared clinical evidence and exchanged experiences. The Questions and discussions were much appreciated by the interactive audience.

After lunch, prof. Tessa Kerre, head of clinic in the HSCT unit at the University Hospital Gent opened the afternoon session about T-cell adoptive therapy. With an increasing understanding of our immune system and tumour biology, the development of new technologies and new generations of drugs, sometimes spectacular results are being achieved in previously difficult-to-treat cancers. She gave us a better understanding of the functioning of our immune system and many possibilities in the future for our HSCT patients.  In addition, good patient-tailored communication remains crucial in immunotherapy treatments.

The next topic about CRS and neurotoxicity in CAR-T cells was presented by dr. Koen Debackere from the University Hospitals in Leuven.  He took us through the literature and described clear the outcomes and side effects of CAR-T. Both screening tools and nursing preparation and assessments were well discussed.

Anneleen Vanhellemont, CNS at the University Hospitals Leuven provided as a real storyteller, an overview of the current cell therapy options in Multiple Myeloma patients. For the last three decades, High dose chemotherapy with autologous stem cell transplantations has been an integral part of the management of young and fit elderly patients with NDMM. Although Allogenic stem cell transplantation has high treatment-related morbidity and mortality. She concluded that CAR T-cell therapy is promising, but there is a need for new strategies to improve outcomes and costs.

Marijke Quaghebeur, CNS haematology from the University Hospital Gent, talked in her session about how to prepare our patients for cell therapy.  An interdisciplinary approach offers the best overall patient outcomes. Haematological nurses have a pivotal role in impairment prevention & response strategies before and during treatment and post-transplant survivorship. Their comprehensive insight into the patient and family care and support systems enables appropriate referrals throughout the cell therapy pathway.

The next speaker was Gaëlle Van Butsel, psychologist and researcher about the end of life care and donor challenges at the University Hospital Gent. Her topic about the early and systematic integration of palliative care in cellular therapy received a lot of attention from the audience. Literature on this topic was reviewed and some ethical topics were mentioned. Traditionally palliative care and early palliative care are explained with life-prolonging or curative treatment. Also, nurses have to be aware of this evolution and be part of this care team.  

Finally, prof. Hélène Schoemans, a transplant physician at University Hospitals Leuven came with an inspiring presentation. She gave an overview of the evolution of patient involvement in HSCT, but also in clinical trials. Often-asked questions: are our patients enough involved during and after their cell therapy? Most post-transplant care is happening at home. Concepts such as self-management, health literacy, medical adherence and lifestyle choices are crucial. Finally, also the care of the caregivers and their involvement deserved further attention.

At the end of the day, there was the yearly annual national chairs meeting. Nurses chairs from all different countries were invited to present the activities of their national EBMT group from the last year. Everybody was happy to have this meeting as a live event, where questions and experiences are shared.

6th Research Study Day

Summary report written by Annika Kisch, Chairperson NG Research Committee

On the 7th of October 2022, the 6th EBMT Nurses Group Research Study Day was arranged by the NG Research Committee. The Research Study Day highlights the valuable contribution of nursing research to the body of knowledge, presents examples of this type of work and provides support and education to those who aspire to undertake research in this area. The main objective of this day was to inspire nurses to “do research” by sharing practical tips and giving opportunities for collaboration and hearing nurses describe their own research experiences. For this, we invited the award winner of the Best research abstract at the EBMT Annual meeting 2022. Our study day this year focused on “Ethics in research”, with the purpose to inspire nurses to reflect on ethics and convey knowledge from various knowledgeable speakers. We had inspiring guest speakers who shared their valuable knowledge about Ethics in research, and about 30 active and engaged participants.

The day opened with an inspiring presentation from Dr Shivadas Sivasubramaniam from the School of Human Sciences, University of Derby, UK. He gave us an overview of the Research cycle, focusing on ethics in each step, from the Research idea to Translation from research and practice. Dr Shiva talked about how Ethics in research is about doing the right thing. But what is that? He gave us a lot of eye-openers about for example the complexity of anonymity and participant protection, with a need for continuous reflections and discussions.

The second presentation was by Ariadna Domènech, a registered nurse from Barcelona, Spain, and she is also the WP nurse in the Autoimmune Diseases Working Party. She presented the work of her group: Informal caregiver of the HSCT recipient: the profile, quality of life impact, and preliminary results in a third-level Spanish hospital. This was the Best Research Abstract Award winner at EBMT 2022, and Ariadna gave an inspiring presentation of their work with a focus on the quality of life, anxiety and depression among informal caregivers.

After the coffee break Julia Krumme, Philosopher and Ethicist, from Augsburg University of Applied Sciences, Germany gave us an interesting presentation about Theoretical input about ethics in research. This included an overview of what Ethics is and the six principles of Ethical Research: Favorable risk-benefit ratio, Respect for participants, Informed consent, Integrity & Transparency, Responsibility & Accountability, and Independence of Research. This was a great introduction to the workshop in the afternoon.

Before lunch, Isabel Salcedo, from Madrid Spain, and a member of the NG Research Committee talked about Ethics in publication. It became obvious that this is a difficult and important area in research, and Isabel pointed out that the publication of research results is an ethical obligation. Isabel also talked about criteria for authorship versus acknowledgements with the importance of checking the Journal Guide for Authors and the importance of ensuring visibility and diversity in research contributions, by using tools, eg. CRediT (Contributor Roles Taxonomy) and tenzing.

The program for the afternoon was a workshop about Ethics in research: Ethical reflections and moral deliberation about practical examples of research, led by Julia Krumme. Julia pointed out different and difficult questions about ethics in research, which we discussed in smaller groups and then in the bigger group. Areas we focused on were Asking the right questions when planning and doing research, Informed consent and Gift/Honorary authorship. These questions opened up interesting discussions and also led to new questions, highlighted the importance of discussing ethics and come up with further questions within our research groups.

Hilda Mekelenkamp, chairperson NG pediatric committee and PDWP nurse, shares her experiences from the Research Study Day:

On October 7th, the 6th Research Study Day took place in Brussels. We started the day with an early working party nurses' meeting. Working party nurses are the closest contacts to the EBMT working parties. These nurses meet four times a year. Once at the Annual meeting, once during the International Study Day/Research Study Day, and twice online. It was great to meet each other face-to-face today after a few years of meeting online. All working party nurses presented their achievements. There was room to discuss challenges and opportunities in our roles as working party nurses. It is supportive to hear ideas from others and to see how other working party nurses find a way to collaborate in research or education within the working party.

The Research Study Day focused on 'Ethics in research. Dr. Shiva from the University of Derby introduced us to the research cycle and focused on ethics in each step in an inspiring way. Ariadna Domènech presented an exciting and thorough study of her and her colleagues 'Informed caregiver of the HSCT recipient: the profile, quality of life impact, preliminary results in a third level Spanish hospital’. Ariadna and her group were the well-deserved winners of the best research abstract award of the 48th Annual meeting.

In the second session, Julia Krumme spoke about 'Theoretical input about ethics in research and Isabel Salcedo about 'Ethics in publication'. Session three was a workshop about ethics in research by Julia Krumme: Ethical reflections and moral deliberation about practical examples of research. This workshop stimulated the attendees to reflect on and discuss informed consent and co-authorship. It was inspiring to discuss each other's viewpoints and to hear experiences from different perspectives. In conclusion, it was an inspirational day with fruitful discussions and valuable contacts. I recommend that other SCT nurses join these relatively small meetings because they give many opportunities to exchange experiences and learn from each other.