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Surviving the cure: long term followup of hematopoietic cell transplant recipients

Abstract

Advances in hematopoietic cell transplantation (HCT) have led to an increasing number of transplant survivors. However, long-term survival is challenged by late relapse, late complications and late non-relapse mortality, and HCT survivors need continued lifelong surveillance for screening, early detection and timely treatment of late complications such as secondary cancers, late infections and organ toxicity. Guidelines for screening and preventive practices for pediatric and adult survivors of autologous and allogeneic HCT were updated and published in 2012. However, several barriers to the care of HCT survivors and routine utilization of these guidelines in clinical practice exist. Examples include paucity of and challenges to conducting prospective randomized trials for screening and prevention of late complications, lack of resources to manage late effects at the level of transplant centers and community health care providers, and inadequate tools to facilitate care and followup of HCT survivors. We summarize the long-term followup guidelines in this review, discuss ways that providers can integrate and utilize them for the care of their patients, and identify areas for research that can inform and increase the utilization of screening and prevention guidelines in clinical practice.

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Acknowledgements

We gratefully acknowledge the time and effort contributed by the writing committee members who participated in the development of 2012 guidelines for ‘Recommended screening and preventive practices for long-term survivors after hematopoietic cell transplantation’. Members included: Mahmoud Aljurf, Yoshiko Atsuta, Carmem Bonfim, Linda J Burns, Naeem Chaudhri, Stella Davies, Stephanie Lee, Shinichiro Okamoto, Adriana Seber, Gerard Socie, Jeff Szer, Maria Teresa Van Lint, Andre Tichelli and John Wingard.

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Correspondence to N S Majhail.

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Majhail, N., Douglas Rizzo, J. Surviving the cure: long term followup of hematopoietic cell transplant recipients. Bone Marrow Transplant 48, 1145–1151 (2013). https://doi.org/10.1038/bmt.2012.258

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Keywords

  • hematopoietic cell transplantation
  • long-term survival
  • late complications
  • screening
  • preventive practices

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