Psychiatric Monitoring in Children Undergoing Hematopoietic Stem Cell Transplantation: A Current Approach from Child Psychiatry and Hematology-Oncology Perspectives

Öz

Hematopoietic stem cell transplantation (HSCT) is a life saving intervention for pediatric malignancies and several non-malignant hematological or genetic disorders. However, this intensive treatment process may lead to long-term psychiatric and neurocognitive complications beyond its physical impact. Emerging evidence suggests that children undergoing HSCT are at risk for anxiety, depression, attentional problems, and executive function deficits, often persisting years after treatment. This review explores the psychiatric and neurocognitive outcomes following HSCT in childhood and examines early intervention approaches to mitigate these effects. It also discusses the psychological burden on parents and caregivers, emphasizing the need for routine psychosocial screening and integrated mental health care in survivorship protocols. A multidisciplinary approach, incorporating child psychiatry, is essential for optimal long-term outcomes. Furthermore, identifying reliable biomarkers and neurodevelopmental risk factors early in the transplantation trajectory may enable more personalized and timely psychiatric interventions. Ultimately, embedding mental health support as a core component of HSCT care pathways rather than an ancillary service represents a critical step toward improving the holistic well-being and quality of life of pediatric survivors.

Anahtar Kelimeler

• stem cell transplantation
• childhood
• neurocognitive model

Hematopoietik Kök Hücre Nakli Geçiren Çocuklarda Psikiyatrik İzleme: Çocuk Psikiyatrisi ve Hematoloji-Onkoloji Perspektiflerinden Güncel Bir Yaklaşım

Öz

Hematopoietik kök hücre transplantasyonu (HKHT), pediatrik malignitelerin ve çeşitli malign olmayan hematolojik veya genetik bozuklukların tedavisinde hayat kurtarıcı bir müdahaledir. Ancak bu yoğun tedavi süreci, fiziksel etkilerinin ötesinde uzun vadeli psikiyatrik ve nörokognitif komplikasyonlara yol açabilmektedir. Giderek artan kanıtlar, HKHT uygulanan çocukların anksiyete, depresyon, dikkat sorunları ve yürütücü işlev bozuklukları açısından risk altında olduğunu ve bu sorunların tedaviden yıllar sonra dahi sürebildiğini göstermektedir. Bu derleme, çocukluk çağında HKHT sonrası ortaya çıkan psikiyatrik ve nörokognitif sonuçları ele almakta ve bu etkileri azaltmaya yönelik erken müdahale yaklaşımlarını incelemektedir. Aynı zamanda ebeveynler ve bakım verenler üzerindeki psikolojik yükü de tartışarak, sağkalım protokollerinde rutin psikososyal tarama ve entegre ruh sağlığı bakımının gerekliliğini vurgulamaktadır. Uzun vadeli sonuçların iyileştirilmesi için çocuk psikiyatrisini de kapsayan multidisipliner bir yaklaşım büyük önem taşımaktadır. Bunun yanı sıra, transplantasyon sürecinin erken döneminde güvenilir biyobelirteçlerin ve nörogelişimsel risk faktörlerinin belirlenmesi, daha kişiselleştirilmiş ve zamanında psikiyatrik müdahalelerin uygulanmasını mümkün kılabilir. Son olarak, ruh sağlığı desteğinin yardımcı bir hizmet olarak değil, HKHT bakım süreçlerinin temel bir bileşeni olarak konumlandırılması; pediatrik sağkalımcıların bütüncül iyilik hali ve yaşam kalitesinin artırılması yolunda kritik bir adımı temsil etmektedir.

Anahtar Kelimeler

• hematopoietik kök hücre nakli
• çocuk
• nörobilişsel model

Kaynakça

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