Blood and Marrow Transplantation Long Term ManagementHematopoietic cell transplantation (HCT) provides curative therapy for a variety of diseases. Over the past several decades, significant advances have been made in the field of HCT, to the point where HCT has become an integral part of treatment modality for a variety of hematologic malignancies and some nonmalignant diseases. HCT remains an important treatment option for a wide variety of hematologic and nonhematologic disorders, despite recent advances in the field of immunologic therapies. Factors driving this growth include expanded disease indications, greater donor options (expanding unrelated donor registries and haploidentical HCT), and accommodation of older and less fit recipients.
The development of less toxic pretransplant conditioning regimens, more effective prophylaxis of graft-versus-host disease (GVHD), improved infection control, and other advances in transplant technology have resulted in a rapidly growing number of transplant recipients surviving long-term free of the disease for which they were transplanted. The changes over decades in the transplant recipient population and in the practice of HCT will have almost inevitably altered the composition of the long-term survivor population over time. Apart from an increasingly older transplant recipient cohort, the pattern of transplant indications has shifted from the 1990s when chronic myeloid leukemia made up a significant proportion of allo-HCT indications. Changes in cell source, donor types, conditioning regimens, GVHD prophylaxis, and supportive care have all occurred, with ongoing reductions in both relapse and non-relapse mortality (NRM) have been demonstrated.
These patients have increased risks for a variety of late complications, which can cause morbidity and mortality. Most long-term survivors return to the care of their local hematologists/oncologists or primary care physicians, who may not be familiar with specialized monitoring and management of long complications after HCT for this patient population. As HCT survivorship increases, the focus of care has shifted to the identification and treatment of long-term complications that may affect quality of life and long-term morbidity and mortality.
Preventive care as well as early detection and treatments are important aspects to reducing morbidity and mortality in long-term survivors after allo-HCT. This second edition,Blood and Marrow Transplantation Long Term Management: Survivorship after Transplant, provides up-to-date information about diagnosis, screening, treatment, and long-term surveillance of long-term survivors after HCT.
Foreword byProfessor John Barrett vii
Foreword byProfessor John Goldman viii
List of Contributors ix
Section 1 Late effects concepts 1
1 Introduction to longterm survivorship after hematopoietic cell transplantation 3Bipin N. Savani and André Tichelli
2 International Blood and Marrow Registries: trends on longterm data collection 6Rachel Phelan, Jakob R. Passweg, Helen Baldomero, Minako Iida, Yoshiko Atsuta, Shinichiro Okamoto, Mahmoud Aljurf, Feras Alfraih, and Bronwen E. Shaw
3 Longterm followup program and transplant clinic setup 14André Tichelli, Bipin N. Savani, Shahrukh K. Hashmi, Navneet S. Majhail, and Alicia Rovó
4 Telemedicine in patient care of longterm transplant survivors 25Catherine J. Lee, Mihkaila Wickline, and Mary E.D. Flowers
5 Longterm followup calendar 33André Tichelli, Bipin N. Savani, Shahrukh K. Hashmi, Navneet S. Majhail, and Alicia Rovó
6 Late effects postallogeneic hematopoietic stem cell transplantation 38Shahrukh K. Hashmi and Yoshihiro Inamoto
7 Late effects postautologous hematopoietic stem cell transplantation 47Rajshekhar Chakraborty and Betty K. Hamilton
8 Longterm followup of children 58Paul A. Carpenter
9 Graftversushost disease and late effects after hematopoietic stem cell transplantation 73David Michonneau, Aurélien Sutra del Galy, and Gérard Socié
10 Screening and prevention guidelines for hematopoietic cell transplant survivors 80Neel S. Bhatt, J. Douglas Rizzo, and Navneet S. Majhail
11 Biology of survivorship after blood or marrow transplantation 92Smita Bhatia
Section 2 Specific late effects 101
12 Second malignancies 103Aurélien Sutra del Galy, David Michonneau, and Gérard Socié
13 Antiinfective prophylaxis, immunization and prevention of late infectious complications 112Per Ljungman
14 Seasonal respiratory viral infections 119Nosha Farhadfar, Zeina AlMansour, and John R. Wingard
15 Monitoring and management of hepatitis B, C, and HIV infection before and after transplantation 132Enric Carreras and Montserrat Rovira
16 Skin chronic GVHD 140Attilio Olivieri, Anna Campanati, Gaia Goteri, and Andrea Bacigalupo
17 Ocular complications 166Alicia Rovó, André Tichelli, and Yoshihiro Inamoto
18 Management of oral and dental complications 176Hildegard T. Greinix
19 Thyroid disease: monitoring and management guidelines 183Juliana Matthews, Leslee Matheny, and Shubhuda Jagasia
20 Pretransplant considerations in gender, reproductive, and sexual health 189Dana Shanis, Jeanne Murphy, Kate Debiec, Betty K. Hamilton, Shawna Boyle, and Pamela Stratton
21 Posttransplant Considerations in Gender, Reproductive, and Sexual Health 198Jeanne Murphy, Dana Shanis, Kate Debiec, Betty K. Hamilton, Shawna Boyle, and Pamela Stratton
22 Fertility issues, fertility preservation, and pregnancy outcome in longterm survivors 211Alicia Rovó, Alison W. Loren, André Tichelli, and Nina Salooja
23 Sexual Dysfunction in LongTerm Survivors 221Rebecca L. Hunter, Sarah Thilges, Janna Gordon, Kristy Luke, Karla Cavazos, Emilee Moeke, Colleen Bruen, and Sunita Nathan
24 Late noninfectious pulmonary complications 231Ayman O. Soubani
25 Cardiac and arterial complications 241Alicia Rovó and André Tichelli
26 Cardiovascular risk factors 251Kimberley Doucette and Minoo Battiwalla
27 Gastrointestinal complications 260Sumona Bhattacharya, Steven Pavletic, and Theo Heller
28 Hepatic Complications 271Christy Ann L. Gilman, Christopher Koh, Steven Pavletic, and Theo Heller
29 Renal complications 278Insara Jaffer Sathick and Sangeeta Hingorani
30 Posttransplantation bone disease: prevalence, surveillance, prevention, and management 287Christine N. Duncan
31 Late neurologic complications 300Enrico Maffini
32 Neurocognitive dysfunction 312David Buchbinder and Angela Scherwath
33 Psychological Distress 330Anna Barata, Aasha I. Hoogland, and Heather S. L. Jim
34 Evaluation and management of fatigue in survivors of allogeneic hematopoietic stem cell transplantation 337Sandra A. Mitchell
35 Social Issues 349Sanghee Hong and Navneet S. Majhail
36 Healthrelated quality of life in adult and pediatric survivors 355Sandra A. Mitchell, Lori Wiener, Jenny Hoag, Abigail Fry, and Margaret F. Bevans
Section 3 Supportive care and patients reported outcomes 381
37 Immunosuppressive agents and monitoring in longterm survivors 383Kathryn A. Culos and Katie S. Gatwood
38 Nutritional support and nutritional supplementation 393Shigeo Fuji
39 Daily routines and healthy lifestyle guidelines 397Melissa Logue
40 Prevalent psychosocial adjustment issues and solutions: lifestyle and social challenges 402Katrina M. Stokes
41 Complementary and alternative medicine in HSCT 406Ibrahim N. Muhsen, Bipin N. Savani,, and Shahrukh K. Hashmi
42 Impact of adherence in outcome of longterm survivors 413Corien Eeltink and Annika Kisch
43 Prominent role of allied health professionals 418Catherine E. Lucid
44 Patient reported outcomes 420Hélène Schoemans
45 Caregivers of longterm survivors 428Angela Moreschi Woods
46 Patients perspective: memoir of a recovered lymphomaniac 434Michael Brown
Appendix 1 Commonly used transplantrelated medications in longterm survivors 442Kathryn A. Culos and Katie S. Gatwood
Appendix 2 The eGVHD App 445Hélène Schoemans
Index 448
