Recommended screening and preventive practices for long-term survivors after hematopoietic cell transplantation

Abstract

Advances in hematopoietic cell transplantation (HCT) technology and supportive care techniques have led to improvements in long-term survival after HCT. Emerging indications for transplantation, introduction of newer graft sources (e.g. umbilical cord blood) and transplantation of older patients using less intense conditioning regimens have also contributed to an increase in the number of HCT survivors. These survivors are at risk for developing late complications secondary to pre-, peri- and post-transplant exposures and risk-factors. Guidelines for screening and preventive practices for HCT survivors were published in 2006. An international group of transplant experts was convened in 2011 to review contemporary literature and update the recommendations while considering the changing practice of transplantation and international applicability of these guidelines. This review provides the updated recommendations for screening and preventive practices for pediatric and adult survivors of autologous and allogeneic HCT.

National Institutes of Health Hematopoietic Cell Transplantation Late Effects Initiative: The Subsequent Neoplasms Working Group Report

“…194–196 The Children’s Oncology Group (COG) created long-term follow-up guidelines (www.survivorshipguidelines.org) for children, adolescent, and young adults who underwent HCT. 197 Consensus-based recommendations for screening and prevention of solid cancers were adapted from those for the general population through collaboration of the CIBMTR Late Effects and Quality of Life Working Committee and the EBMT Complications and Quality of Life Working Party for children and adults.…”

Hematopoietic Stem Cell Transplantation and Current Nutritional Approaches: Review

“…Nakil işlemi için başlan-gıçta sadece kemik iliğinden kök hücre elde edildiğinden işlem geleneksel olarak "kemik iliği nakli" olarak adlandırılmışsa da; günümüzde kemik iliği haricinde diğer dokulardan da kök hücre elde edilebildiğinden "hematopoetik kök hücre nakli" deyimi tercih edilmektedir. 3 …”

“…Bu sayede erken dö-nemde görülebilen mortalite ve komplikasyonlar azaltılmaya çalışılmaktadır. 3 Günümüzde daha çok tercih edilen otolog KHN'deki amaç, yüksek doz kemoterapi sonrasında vücudun yeni kan hücresi oluşturmasına yardımcı olmaktır. Allojeneik KHN'de ise yüksek doz kemoterapi kullanılmakla beraber amaç; lösemi hücre-lerinin, donörün bağışıklık sistemi hücreleri tarafından yok edilmesini sağlamaktır.…”

“…Ancak bu sırada vericinin hücreleri alıcının sağlıklı vücut hücrelerine karşı da immün reaksiyon göstererek hasarlanmaya neden olduğundan hastada diyare, hiperbilirubinemi ve dermatitler oluşmaktadır. 3 Allojeneik KHN'den sonra kullanılan kemoterapötik-lere bağlı olarak hastalarda bulantı, kusma ve oro-faringeal mukozitler gelişmektedir. 4 KÖK HÜCRE NAKLİ SÜRESİNCE BESLENME DESTEĞİ Çocuklarda beslenme desteğinin amacı; büyüme ve gelişmeyi sağlama, besin ögesi eksikliklerinden korunma, immün ve gastrointestinal fonksiyonların sürdürülmesi ve yeterli beslenmenin sağlanması-dır.…”

A retrospective multi-centre study of the effects of allogeneic haematopoietic SCT on pulmonary function

“…The limited availability of PFT data was surprising given HSCT guidelines recommend regular clinical assessment for lung complications and measurement of PFTs in patients with evidence of respiratory disease or in all patients with chronic GvHD. 7 As post-HSCT BO often presents clinically only after substantial loss of lung function, the low frequency of lung function testing is of concern. We suggest that closer adherence to lung function testing guidelines in HSCT patients may help us identify the patients developing BO at an earlier stage, when therapeutic intervention could be more effective.…”