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Initial release: EBMT Handbook skill for AI coding agents
Packages the EBMT Handbook 8th Edition (2024) as a publishable skill following the vercel-labs/skills protocol. Includes GitHub Action for automated .skill packaging and releases. Co-Authored-By: Claude Opus 4.6 (1M context) <noreply@anthropic.com>
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‎.github/workflows/release.yml‎

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name: Build & Release Skill
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on:
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push:
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branches: [main]
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workflow_dispatch:
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permissions:
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contents: write
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jobs:
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build:
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runs-on: ubuntu-latest
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steps:
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- name: Checkout
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uses: actions/checkout@v4
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- name: Set version from SHA
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id: version
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run: |
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SHORT_SHA="${GITHUB_SHA::7}"
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echo "sha=${SHORT_SHA}" >> $GITHUB_OUTPUT
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echo "Version: ${SHORT_SHA}"
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- name: Package skill
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run: |
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cd ebmt-handbook
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zip -r ../ebmt-handbook.zip .
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cd ..
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cp ebmt-handbook.zip ebmt-handbook.skill
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- name: Upload artifact
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uses: actions/upload-artifact@v4
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with:
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name: ebmt-handbook-${{ steps.version.outputs.sha }}
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path: ebmt-handbook.skill
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- name: Create GitHub Release
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env:
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GH_TOKEN: ${{ secrets.GITHUB_TOKEN }}
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run: |
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SHORT_SHA="${GITHUB_SHA::7}"
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TAG="v0.1.0-${SHORT_SHA}"
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cat > release-notes.md <<EOF
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## EBMT Handbook Skill
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**Version:** \`${SHORT_SHA}\`
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**Commit:** ${GITHUB_SHA}
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### Install
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\`\`\`bash
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npx skills add htlin222/ebmt-handbook-skill
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\`\`\`
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Or download the \`.skill\` file from assets below.
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EOF
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gh release create "${TAG}" \
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--title "ebmt-handbook skill ${TAG}" \
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--notes-file release-notes.md \
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ebmt-handbook.skill

‎.gitignore‎

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.DS_Store
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*.zip
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*.skill

‎README.md‎

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# ebmt-handbook
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[![Build & Release Skill](https://github.com/htlin222/ebmt-handbook-skill/actions/workflows/release.yml/badge.svg)](https://github.com/htlin222/ebmt-handbook-skill/actions/workflows/release.yml)
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[![GitHub Release](https://img.shields.io/github/v/release/htlin222/ebmt-handbook-skill?include_prereleases&label=skill%20version)](https://github.com/htlin222/ebmt-handbook-skill/releases/latest)
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[![License: CC BY 4.0](https://img.shields.io/badge/License-CC_BY_4.0-lightgrey.svg)](https://creativecommons.org/licenses/by/4.0/)
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[![Skills Protocol](https://img.shields.io/badge/protocol-vercel--labs%2Fskills-blue)](https://github.com/vercel-labs/skills)
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[![Compatible Agents](https://img.shields.io/badge/agents-40%2B-green)](https://github.com/vercel-labs/skills#supported-agents)
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> EBMT Handbook 8th Edition (2024) — Hematopoietic Cell Transplantation & Cellular Therapies clinical guideline skill for AI coding agents.
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## Install
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```bash
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# Project-level (recommended)
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npx skills add htlin222/ebmt-handbook-skill
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# Global
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npx skills add -g htlin222/ebmt-handbook-skill
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# Specific agent
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npx skills add htlin222/ebmt-handbook-skill --agent claude-code
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```
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## What it does
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This skill equips AI agents with structured clinical knowledge from the **EBMT Handbook, 8th Edition (2024)**, the standard reference for hematopoietic cell transplantation and cellular therapies.
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When activated, the agent can:
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- **Route questions** to the correct chapter via a clinical decision tree
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- **Cite sources** with `📖 EBMT Handbook 8th ed. Ch. N` attribution
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- **Run clinical calculators** (BSA, CrCl, HCT-CI score, GVHD grading, drug dosing)
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- **Output checklists** for pre-HCT evaluation, febrile neutropenia, and more
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- **Cover 95+ chapters** spanning pre-transplant assessment, donor selection, conditioning, GVHD, infections, organ complications, relapse, CAR-T, and disease-specific indications
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## Trigger keywords
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`HCT`, `移植`, `骨髓`, `幹細胞`, `GVHD`, `CAR-T`, `造血`, `transplant`, `stem cell`, `bone marrow`
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## Skill structure
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```
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ebmt-handbook/
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├── SKILL.md # Skill definition (frontmatter + instructions)
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├── scripts/
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│ └── hct_tools.py # Clinical calculators
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├── references/
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│ ├── part2-biological.md # HLA, immune reconstitution (Ch.7-10)
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│ ├── part3-methodology.md # Transplant methodology (Ch.11-22)
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│ ├── part4-management.md # General management, vaccines (Ch.22-34)
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│ ├── part5-complications.md # GVHD, infections, iron overload (Ch.35-47)
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│ ├── part6-organ.md # Organ complications (Ch.48-56)
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│ ├── part7-relapse.md # Relapse, CAR-T (Ch.57-65)
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│ ├── part8-modalities.md # Special transplant modalities (Ch.63-69)
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│ └── part9-indications.md # Disease indications, pediatric (Ch.70-95)
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└── audit_payload.json # Skill audit metadata
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```
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## Source
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**Book:** The EBMT Handbook: Hematopoietic Cell Transplantation and Cellular Therapies, 8th edition (2024)
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**Editors:** Sureda A, Corbacioglu S, Greco R, Kröger N, Carreras E
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**Publisher:** Springer — Open Access CC BY 4.0
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**URL:** https://www.ncbi.nlm.nih.gov/books/NBK608238/
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## Protocol
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This skill follows the [vercel-labs/skills](https://github.com/vercel-labs/skills) protocol. Each push to `main` triggers a GitHub Action that packages the skill as a `.skill` file (zip archive) and creates a release tagged with the commit SHA.
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## License
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Content derived from the EBMT Handbook is licensed under [CC BY 4.0](https://creativecommons.org/licenses/by/4.0/).

‎ebmt-handbook/SKILL.md‎

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---
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name: ebmt-handbook
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description: >
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EBMT Handbook 第8版（2024）造血細胞移植（HCT）與細胞治療臨床指引技能。
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當使用者詢問任何移植病人相關問題時，必須立即啟用本技能，包含：
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移植前評估、捐贈者選擇、預處理方案、幹細胞來源、GVHD 預防與治療、
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感染處理（細菌/黴菌/病毒）、器官併發症（肝/腎/肺/神經）、移植後復發管理、
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CAR-T 細胞治療、各疾病移植適應症（AML/ALL/MDS/淋巴瘤/骨髓瘤等）、
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移植後長期追蹤、兒童移植、疫苗接種、心理照護。
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每次回答必須標明出處：「📖 來自 EBMT Handbook 第8版 第 N 章」。
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使用者問 HCT、移植、骨髓、幹細胞、GVHD、CAR-T、造血、移植病人 等關鍵字時，強制觸發本技能。
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---
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# EBMT Handbook 第8版 臨床指引技能
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**書籍**：The EBMT Handbook: Hematopoietic Cell Transplantation and Cellular Therapies, 8th edition (2024)
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**編輯**：Sureda A, Corbacioglu S, Greco R, Kröger N, Carreras E
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**出版**：Springer; Open Access CC BY 4.0
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**來源**：https://www.ncbi.nlm.nih.gov/books/NBK608238/
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---
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## ⚙️ 核心規則（每次回答必須遵守）
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1. **來源標示**：每段落標明 `📖 來自 EBMT Handbook 第8版 第 N 章`
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2. **來源區分**：
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- `[書中驗證]`：內容來自已 fetch 的原書章節
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- `[模型補充]`：來自 Claude 訓練知識，請交叉核對原文
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3. **知識截止警告**：回答藥物核准、新指引等議題時，加上：
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> 📅 本資訊以 EBMT Handbook 第8版（2024）為準，請確認是否有最新更新。
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4. **臨床第一**：先給出可操作建議，再補充原理
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5. **計算工具**：劑量/評分/CrCl 請執行 `scripts/hct_tools.py`，每次輸出自帶 safety disclaimer
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6. **死連結保護**：若 references/ 中無對應檔案，誠實告知「此章節尚未詳細收錄，請查閱原書」
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7. **不確定時**：明確說明不確定，建議查閱原書 URL：https://www.ncbi.nlm.nih.gov/books/NBK608238/
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---
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## 📚 快速章節路由表
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根據問題類型，先查閱對應章節，再深入 references/ 資料夾。
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### 🔍 問題 → 章節 對照
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| 問題類型 | 章節 | 深入參考 |
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|---------|------|---------|
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| 移植前評估 / 適應症判斷 | Ch.11 | references/part3-methodology.md |
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| 捐贈者選擇（成人/兒童）| Ch.12 | references/part3-methodology.md |
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| HLA 配對原則 | Ch.9 | references/part2-biological.md ✅ |
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| 預處理方案（MAC/RIC/NMA）| Ch.13 | references/part3-methodology.md |
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| 幹細胞來源選擇（BM/PB/CB）| Ch.14 | references/part3-methodology.md |
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| 骨髓採集 | Ch.15 | references/part3-methodology.md |
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| 幹細胞動員與採集 | Ch.16, 17 | references/part3-methodology.md |
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| 臍帶血 | Ch.18, 64 | references/part8-modalities.md |
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| Graft 處理/冷凍保存 | Ch.19, 20 | references/part3-methodology.md |
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| Chimerism 監測 | Ch.21 | references/part3-methodology.md |
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| 移植後追蹤 | Ch.22 | references/part3-methodology.md |
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| 血管通路（CVC）| Ch.23 | references/part4-management.md |
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| 輸血支持 | Ch.24 | references/part4-management.md |
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| 營養支持 | Ch.25 | references/part4-management.md |
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| **GVHD 預防** | **Ch.26** | references/part4-management.md |
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| 感染控制/隔離 | Ch.27, 28 | references/part4-management.md |
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| 疫苗接種 | Ch.29 | references/part4-management.md |
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| 心理照護 | Ch.30 | references/part4-management.md |
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| 藥物交互作用 | Ch.31 | references/part4-management.md |
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| 中性球低燒 | Ch.35 | references/part5-complications.md |
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| 細菌感染 | Ch.36 | references/part5-complications.md |
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| **黴菌感染** | **Ch.37** | references/part5-complications.md |
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| **病毒感染**（CMV/EBV/HHV6…）| **Ch.38** | references/part5-complications.md |
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| 其他感染（結核/弓漿蟲）| Ch.39 | references/part5-complications.md |
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| 出血/血栓 | Ch.40 | references/part5-complications.md |
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| Graft failure | Ch.41 | references/part5-complications.md |
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| SOS/VOD（肝竇阻塞症候群）| Ch.49 | references/part6-organ.md |
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| **急性 GVHD** | **Ch.43** | references/part5-complications.md |
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| **慢性 GVHD** | **Ch.44** | references/part5-complications.md |
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| PTLD | Ch.45 | references/part5-complications.md |
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| 鐵過載 | Ch.46 | references/part5-complications.md |
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| 次發性腫瘤 | Ch.47 | references/part5-complications.md |
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| 眼/口腔併發症 | Ch.48 | references/part6-organ.md |
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| 腸胃道併發症 | Ch.50 | references/part6-organ.md |
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| 出血性膀胱炎/腎功能 | Ch.51 | references/part6-organ.md |
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| 肺部非感染性併發症 | Ch.52 | references/part6-organ.md |
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| 神經系統併發症 | Ch.53 | references/part6-organ.md |
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| 皮膚/肌肉骨骼 | Ch.54 | references/part6-organ.md |
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| 心血管/代謝症候群 | Ch.55 | references/part6-organ.md |
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| 內分泌/生育/性功能 | Ch.56 | references/part6-organ.md |
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| MRD 監測 | Ch.57 | references/part7-relapse.md |
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| 復發藥物治療（TKI/HMA…）| Ch.58 | references/part7-relapse.md |
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| DLI（供者淋巴球輸注）| Ch.59 | references/part7-relapse.md |
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| CAR-T / 基因療法 | Ch.60 | references/part7-relapse.md |
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| Haploidentical HCT | Ch.65 | references/part8-modalities.md ✅ |
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| 老年移植 | Ch.68 | references/part8-modalities.md ✅ |
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| AML（成人）| Ch.70 | references/part9-indications.md |
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| AML（兒童）| Ch.71 | references/part9-indications.md |
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| ALL（成人）| Ch.72 | references/part9-indications.md |
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| ALL（兒童）| Ch.73 | references/part9-indications.md |
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| MDS | Ch.74, 75 | references/part9-indications.md |
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| 骨髓纖維化/CML | Ch.77 | references/part9-indications.md |
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| 再生不良性貧血/PNH | Ch.78 | references/part9-indications.md |
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| 血色素病變（SCD/Thal）| Ch.80 | references/part9-indications.md |
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| 多發性骨髓瘤 | Ch.81 | references/part9-indications.md |
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| 淋巴瘤（DLBCL/MCL/iNHL）| Ch.84-88 | references/part9-indications.md |
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---
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## 🧠 臨床決策樹（快速分流）
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```
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移植病人問題
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├── 移植前？
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│ ├── 適應症評估 → Ch.11 + Ch.70-95（疾病別）
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│ ├── 捐贈者/來源 → Ch.12, 14, 64, 65
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│ └── 預處理選擇 → Ch.13
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│
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├── 移植中（D-7 到 D+30）？
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│ ├── 感染/發燒 → Ch.35, 36, 37, 38
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│ ├── 器官毒性 → Ch.42（endothelial）, Ch.49（SOS/VOD）
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│ ├── GVHD 預防 → Ch.26
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│ └── 支持照護 → Ch.23-25, 31
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│
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├── 移植後早期（D+30 到 D+100）？
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│ ├── 急性 GVHD → Ch.43
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│ ├── 感染 → Ch.36-39
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│ ├── Graft failure → Ch.41
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│ └── Chimerism → Ch.21
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│
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└── 移植後晚期（D+100 之後）？
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├── 慢性 GVHD → Ch.44
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├── 感染/疫苗 → Ch.29, 38
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├── 器官長期併發症 → Ch.48-56
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├── MRD/復發 → Ch.57-61
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└── 次發腫瘤/生活品質 → Ch.47, 34
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```
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---
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## 🐍 Python 工具使用說明
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當問題涉及以下計算時，執行 `scripts/hct_tools.py`：
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| 需求 | 工具函數 |
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|-----|---------|
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| BSA（體表面積）計算 | `calc_bsa(weight, height)` |
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| CrCl / eGFR 計算 | `calc_crcl(age, weight, creatinine, sex)` |
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| Sorror HCT-CI 評分 | `hct_ci_score(comorbidities_dict)` |
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| GVHD 分期 | `grade_gvhd(skin_pct, bilirubin, stool_vol)` |
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| 藥物劑量試算 | `drug_dose(drug, weight, bsa, renal)` |
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| Checklist 輸出（JSON）| `print_checklist(phase)` |
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執行方式：`python3 /home/claude/ebmt-handbook/scripts/hct_tools.py`
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---
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## 📋 常用 Checklist（直接輸出）
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### 移植前評估 Checklist（Ch.11）
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```json
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{
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"phase": "pre-HCT evaluation",
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"chapter": 11,
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"items": [
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{"category": "疾病評估", "tasks": ["疾病分期確認", "MRD 狀態", "細胞遺傳學/分子標記"]},
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{"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"]},
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{"category": "感染篩檢", "tasks": ["CMV IgG", "EBV", "HSV", "VZV", "HIV", "HBV", "HCV", "梅毒", "結核 IGRA"]},
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{"category": "HLA 配型", "tasks": ["病患 HLA typing 10/10", "捐贈者搜尋"]},
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{"category": "知情同意", "tasks": ["移植風險說明", "生育保存討論", "心理評估"]}
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]
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}
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```
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### 中性球低燒處理 Checklist（Ch.35）
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```json
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{
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"phase": "febrile neutropenia",
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"chapter": 35,
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"items": [
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{"step": 1, "action": "體溫 >38°C 且 ANC <0.5×10⁹/L → 啟動 FN protocol"},
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{"step": 2, "action": "抽血培養 x2（不同部位），含 CVC port"},
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{"step": 3, "action": "30分鐘內給予廣效抗生素（pip/tazo 或 cefepime）"},
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{"step": 4, "action": "評估是否為 high risk（HCT患者均為 high risk）"},
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{"step": 5, "action": "48-72小時仍發燒 → 加上抗黴菌治療"},
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{"step": 6, "action": "懷疑 Aspergillus → GM 抗原、胸部 CT"}
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]
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}
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```
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---
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## 📖 深入閱讀指引
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當需要完整的臨床指引內容，請 `view` 對應 references 檔案：
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```
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view /home/claude/ebmt-handbook/references/part2-biological.md # HLA、免疫重建（Ch.7-10）✅新增
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view /home/claude/ebmt-handbook/references/part3-methodology.md # 移植方法論（Ch.11-22）
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view /home/claude/ebmt-handbook/references/part4-management.md # 一般處置、疫苗（Ch.22-34）
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view /home/claude/ebmt-handbook/references/part5-complications.md # GVHD、感染、鐵過載（Ch.35-47）✅擴充
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view /home/claude/ebmt-handbook/references/part6-organ.md # 器官併發症（Ch.48-56）✅擴充
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view /home/claude/ebmt-handbook/references/part7-relapse.md # 復發/CAR-T（Ch.57-65）
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view /home/claude/ebmt-handbook/references/part8-modalities.md # 特殊移植模式（Ch.63-69）✅新增
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view /home/claude/ebmt-handbook/references/part9-indications.md # 各疾病+兒童適應症（Ch.70-95）✅擴充
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```
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---
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> ⚠️ 本技能提供臨床參考，不取代個別病人的醫療決策。
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> 所有建議均引用自 EBMT Handbook 第8版（2024），請依據最新機構指引調整。

‎ebmt-handbook/audit_payload.json‎

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