Book：The EBMT Handbook: Hematopoietic Cell Transplantation and Cellular Therapies, 8th edition (2024)
Editors：Sureda A, Corbacioglu S, Greco R, Kröger N, Carreras E
Publication：Springer; Open Access CC BY 4.0
Source：https://www.ncbi.nlm.nih.gov/books/NBK608238/
⚙️ Core rules (must be followed in every response)
- Source labeling: label each paragraph with
📖 來自 EBMT Handbook 第8版 第 N 章 - Source distinction：
[書中驗證]: content comes from the fetched original book chapter[模型補充]: comes from Claude's training knowledge, please cross-check against the original text
- Knowledge cutoff warning: when answering topics such as drug approvals, new guidelines, etc., add:
📅 This information is based on the EBMT Handbook 8th edition (2024); please confirm whether there are any latest updates.
- Clinical first: give actionable recommendations first, then supplement with rationale
- Calculation tools: for dosage/scoring/CrCl please execute
scripts/hct_tools.py, and include a safety disclaimer with every output - Dead link protection: if there is no corresponding file in references/, honestly state "This chapter has not yet been collected in detail; please consult the original book"
- When uncertain: clearly state the uncertainty, and recommend consulting the original book URL:https://www.ncbi.nlm.nih.gov/books/NBK608238/
📚 Quick chapter routing table
According to the question type, first consult the corresponding chapter, then go deeper into the references/ folder.
🔍 Question → Chapter mapping
| Question type | Chapter | In-depth reference |
|---|---|---|
| Pre-transplant assessment / indication determination | Ch.11 | references/part3-methodology.md |
| Donor selection (adult/pediatric) | Ch.12 | references/part3-methodology.md |
| HLA matching principles | Ch.9 | references/part2-biological.md ✅ |
| Conditioning regimens (MAC/RIC/NMA) | Ch.13 | references/part3-methodology.md |
| Stem cell source selection (BM/PB/CB) | Ch.14 | references/part3-methodology.md |
| Bone marrow collection | Ch.15 | references/part3-methodology.md |
| Stem cell mobilization and collection | Ch.16, 17 | references/part3-methodology.md |
| Cord blood | Ch.18, 64 | references/part8-modalities.md |
| Graft processing/cryopreservation | Ch.19, 20 | references/part3-methodology.md |
| Chimerism monitoring | Ch.21 | references/part3-methodology.md |
| Post-transplant follow-up | Ch.22 | references/part3-methodology.md |
| Vascular access (CVC) | Ch.23 | references/part4-management.md |
| Transfusion support | Ch.24 | references/part4-management.md |
| Nutritional support | Ch.25 | references/part4-management.md |
| GVHD prevention | Ch.26 | references/part4-management.md |
| Infection control/isolation | Ch.27, 28 | references/part4-management.md |
| Vaccination | Ch.29 | references/part4-management.md |
| Psychological care | Ch.30 | references/part4-management.md |
| Drug interactions | Ch.31 | references/part4-management.md |
| Neutropenic fever | Ch.35 | references/part5-complications.md |
| Bacterial infection | Ch.36 | references/part5-complications.md |
| Fungal infection | Ch.37 | references/part5-complications.md |
| Viral infection（CMV/EBV/HHV6…） | Ch.38 | references/part5-complications.md |
| Other infections (tuberculosis/toxoplasmosis) | Ch.39 | references/part5-complications.md |
| Bleeding/thrombosis | Ch.40 | references/part5-complications.md |
| Graft failure | Ch.41 | references/part5-complications.md |
| SOS/VOD (sinusoidal obstruction syndrome) | Ch.49 | references/part6-organ.md |
| Acute GVHD | Ch.43 | references/part5-complications.md |
| Chronic GVHD | Ch.44 | references/part5-complications.md |
| PTLD | Ch.45 | references/part5-complications.md |
| Iron overload | Ch.46 | references/part5-complications.md |
| Secondary malignancy | Ch.47 | references/part5-complications.md |
| Ocular/oral complications | Ch.48 | references/part6-organ.md |
| Gastrointestinal complications | Ch.50 | references/part6-organ.md |
| Hemorrhagic cystitis/renal function | Ch.51 | references/part6-organ.md |
| Non-infectious pulmonary complications | Ch.52 | references/part6-organ.md |
| Neurological complications | Ch.53 | references/part6-organ.md |
| Skin/musculoskeletal | Ch.54 | references/part6-organ.md |
| Cardiovascular/Metabolic Syndrome | Ch.55 | references/part6-organ.md |
| Endocrine/Fertility/Sexual Function | Ch.56 | references/part6-organ.md |
| MRD Monitoring | Ch.57 | references/part7-relapse.md |
| Relapse Pharmacotherapy (TKI/HMA...) | Ch.58 | references/part7-relapse.md |
| DLI (Donor Lymphocyte Infusion) | Ch.59 | references/part7-relapse.md |
| CAR-T / Gene Therapy | Ch.60 | references/part7-relapse.md |
| Haploidentical HCT | Ch.65 | references/part8-modalities.md ✅ |
| Geriatric Transplantation | Ch.68 | references/part8-modalities.md ✅ |
| AML (Adult) | Ch.70 | references/part9-indications.md |
| AML (Pediatric) | Ch.71 | references/part9-indications.md |
| ALL (Adult) | Ch.72 | references/part9-indications.md |
| ALL (Pediatric) | Ch.73 | references/part9-indications.md |
| MDS | Ch.74, 75 | references/part9-indications.md |
| Myelofibrosis/CML | Ch.77 | references/part9-indications.md |
| Aplastic Anemia/PNH | Ch.78 | references/part9-indications.md |
| Hemoglobinopathies (SCD/Thal) | Ch.80 | references/part9-indications.md |
| Multiple Myeloma | Ch.81 | references/part9-indications.md |
| Lymphoma (DLBCL/MCL/iNHL) | Ch.84-88 | references/part9-indications.md |
🧠 Clinical Decision Tree (Rapid Triage)
移植病人問題
├── 移植前？
│ ├── 適應症評估 → Ch.11 + Ch.70-95（疾病別）
│ ├── 捐贈者/來源 → Ch.12, 14, 64, 65
│ └── 預處理選擇 → Ch.13
│
├── 移植中（D-7 到 D+30）？
│ ├── 感染/發燒 → Ch.35, 36, 37, 38
│ ├── 器官毒性 → Ch.42（endothelial）, Ch.49（SOS/VOD）
│ ├── GVHD 預防 → Ch.26
│ └── 支持照護 → Ch.23-25, 31
│
├── 移植後早期（D+30 到 D+100）？
│ ├── 急性 GVHD → Ch.43
│ ├── 感染 → Ch.36-39
│ ├── Graft failure → Ch.41
│ └── Chimerism → Ch.21
│
└── 移植後晚期（D+100 之後）？
├── 慢性 GVHD → Ch.44
├── 感染/疫苗 → Ch.29, 38
├── 器官長期併發症 → Ch.48-56
├── MRD/復發 → Ch.57-61
└── 次發腫瘤/生活品質 → Ch.47, 34
🐍 Python Tool Usage Instructions
When the question involves the following calculations, execute scripts/hct_tools.py：
| Requirement | Tool Function |
|---|---|
| BSA (Body Surface Area) Calculation | calc_bsa(weight, height) |
| CrCl / eGFR Calculation | calc_crcl(age, weight, creatinine, sex) |
| Sorror HCT-CI Score | hct_ci_score(comorbidities_dict) |
| GVHD Staging | grade_gvhd(skin_pct, bilirubin, stool_vol) |
| Drug Dose Calculation | drug_dose(drug, weight, bsa, renal) |
| Checklist Output (JSON) | print_checklist(phase) |
Execution Method:python3 /home/claude/ebmt-handbook/scripts/hct_tools.py
📋 Common Checklists (Direct Output)
Pre-transplant Evaluation Checklist (Ch.11)
{
"phase": "pre-HCT evaluation",
"chapter": 11,
"items": [
{"category": "疾病評估", "tasks": ["疾病分期確認", "MRD 狀態", "細胞遺傳學/分子標記"]},
{"category": "器官功能", "tasks": ["心臟 ECHO（EF>45%）", "肺功能 FEV1/DLCO", "肝功能", "腎功能 CrCl", "神經功能"]},
{"category": "感染篩檢", "tasks": ["CMV IgG", "EBV", "HSV", "VZV", "HIV", "HBV", "HCV", "梅毒", "結核 IGRA"]},
{"category": "HLA 配型", "tasks": ["病患 HLA typing 10/10", "捐贈者搜尋"]},
{"category": "知情同意", "tasks": ["移植風險說明", "生育保存討論", "心理評估"]}
]
}
Neutropenic Fever Management Checklist (Ch.35)
{
"phase": "febrile neutropenia",
"chapter": 35,
"items": [
{"step": 1, "action": "體溫 >38°C 且 ANC <0.5×10⁹/L → 啟動 FN protocol"},
{"step": 2, "action": "抽血培養 x2（不同部位），含 CVC port"},
{"step": 3, "action": "30分鐘內給予廣效抗生素（pip/tazo 或 cefepime）"},
{"step": 4, "action": "評估是否為 high risk（HCT患者均為 high risk）"},
{"step": 5, "action": "48-72小時仍發燒 → 加上抗黴菌治療"},
{"step": 6, "action": "懷疑 Aspergillus → GM 抗原、胸部 CT"}
]
}
📖 In-depth Reading Guide
When complete clinical guideline content is needed, please view corresponding references file:
view /home/claude/ebmt-handbook/references/part2-biological.md # HLA、免疫重建（Ch.7-10）✅新增
view /home/claude/ebmt-handbook/references/part3-methodology.md # 移植方法論（Ch.11-22）
view /home/claude/ebmt-handbook/references/part4-management.md # 一般處置、疫苗（Ch.22-34）
view /home/claude/ebmt-handbook/references/part5-complications.md # GVHD、感染、鐵過載（Ch.35-47）✅擴充
view /home/claude/ebmt-handbook/references/part6-organ.md # 器官併發症（Ch.48-56）✅擴充
view /home/claude/ebmt-handbook/references/part7-relapse.md # 復發/CAR-T（Ch.57-65）
view /home/claude/ebmt-handbook/references/part8-modalities.md # 特殊移植模式（Ch.63-69）✅新增
view /home/claude/ebmt-handbook/references/part9-indications.md # 各疾病+兒童適應症（Ch.70-95）✅擴充
⚠️ This skill provides clinical reference and does not replace medical decisions for individual patients. All recommendations are cited from the EBMT Handbook 8th edition (2024); please adjust according to the latest institutional guidelines.