Hematopoietic stem cell transplant

Abstract

Children treated with hematopoietic stem cell transplantation (HSCT), particularly allogeneic HSCT, are at particular risk for late effects of therapy. Chronic graft-versus-host disease (cGVHD) is a major cause of morbidity in these survivors. In addition, the source of stem cells and the transplant conditioning regimen (which may include both chemotherapy and total body irradiation) impact survivors’ long-term risks. These risks are frequently compounded by the types of cancer therapy received prior to the transplant. Survivors of allogeneic transplant require lifelong follow-up by a medical team with expertise in this population. This care is directed by guidelines such as those published by the Children’s Oncology Group. Since most body systems can be impacted by HSCT and its therapy, long-term care frequently involves input from multiple medical sub-specialists. Co-ordination of this care through a cancer survivor or HSCT clinic can optimize long-term medical and psychosocial outcomes in HSCT survivors.