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Review
. 2024 Apr;30(4):349-385.
doi: 10.1016/j.jtct.2023.12.001. Epub 2024 Feb 27.

International Recommendations for Screening and Preventative Practices for Long-Term Survivors of Transplantation and Cellular Therapy: A 2023 Update

Seth J Rotz  1 , Neel S Bhatt  2 , Betty K Hamilton  3 , Christine Duncan  4 , Mahmoud Aljurf  5 , Yoshiko Atsuta  6 , Kristen Beebe  7 , David Buchbinder  8 , Peggy Burkhard  9 , Paul A Carpenter  2 , Naeem Chaudhri  5 , Mohamed Elemary  10 , Mahmoud Elsawy  11 , Gregory Mt Guilcher  12 , Nada Hamad  13 , Amado Karduss  14 , Zinaida Peric  15 , Duncan Purtill  16 , Douglas Rizzo  17 , Morgani Rodrigues  18 , Maria Belén Rosales Ostriz  19 , Nina Salooja  20 , Helene Schoemans  21 , Adriana Seber  22 , Akshay Sharma  23 , Alok Srivastava  24 , Susan K Stewart  25 , K Scott Baker  2 , Navneet S Majhail  26 , Rachel Phelan  27
Affiliations
Review

International Recommendations for Screening and Preventative Practices for Long-Term Survivors of Transplantation and Cellular Therapy: A 2023 Update

Seth J Rotz et al. Transplant Cell Ther. 2024 Apr.

Abstract

As hematopoietic cell transplantation (HCT) and cellular therapy expand to new indications and international access improves, the number of HCTs performed annually continues to rise. Parallel improvements in HCT techniques and supportive care entails more patients surviving long term, creating further emphasis on survivorship needs. Survivors are at risk for developing late complications secondary to pretransplantation, peritransplantation, and post-transplantation exposures and other underlying risk factors. Guidelines for screening and preventive practices for HCT survivors were originally published in 2006 and then updated in 2012. An international group of experts was convened to review the contemporary literature and update the recommendations while considering the changing practices of HCT and cellular therapy. This review provides updated pediatric and adult survivorship guidelines for HCT and cellular therapy. The contributory role of chronic graft-versus-host disease (cGVHD) to the development of late effects is discussed, but cGVHD management is not covered in detail. These guidelines emphasize the special needs of patients with distinct underlying HCT indications or comorbidities (eg, hemoglobinopathies, older adults) but do not replace more detailed group-, disease-, or condition-specific guidelines. Although these recommendations should be applicable to the vast majority of HCT recipients, resource constraints may limit their implementation in some settings.

Keywords: BMT; HCT; Late-effects; Prevention; Recommendations; Screening; Survivorship; TCT; Transplantation.

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Conflict of interest statement

Y.A. reports lecture fees from Otsuka Pharmaceutical, Chugai Pharmaceutical, Novartis Pharma KK, and AbbVie GK; honoraria from Meiji Seika Pharma; and consultant fees from JCR Pharmaceuticals and Kyowa Kirin. G.G. reports serving as Principal Investigator of Project Sickle Cure, a Sickle Cell Transplant Advocacy and Research Alliance Study partially funded by bluebird bio, and serving on the steering committee of a STAR clinical trial for which Bristol Myers Squibb has provided funding. N.M. reports consulting for Anthem, Inc and stock ownership in HCA Healthcare. R.P. reports advisory board participation for bluebird bio, and research funding from Amgen. S.R. reports serving as a medical monitor for the Resource for Clinical Investigation in Blood and Marrow Transplantation (RCI BMT). H.S. reports personal fees from Incyte, Janssen, Novartis, Sanofi, and the Belgian Hematological Society (BHS); research grants from Novartis and the BHS; and nonfinancial support from Gilead, Pfizer, the European Society for Blood and Marrow Transplantation, and the Center for International Bone Marrow Transplantation Research. A.S. reports consulting fees from Spotlight Therapeutics, Medexus, Vertex Pharmaceuticals, Sangamo Therapeutics, and Editas Medicine; serving as a medical monitor for RCI BMT; research funding from CRISPR Therapeutics; and honoraria from Vindico Medical Education. Dr Sharma is the St Jude Children’s Research Hospital site principal investigator of clinical trials for genome editing of sickle cell disease sponsored by Vertex Pharmaceuticals/CRISPR Therapeutics (NCT03745287), Novartis Pharmaceuticals (NCT04443907), and Beam Therapeutics (NCT05456880). The industry sponsors provide funding for the clinical trial, which includes salary support paid to Dr Sharma’s institution.

Figures

Figure 1.
Figure 1.
International societies represented. American Society for Transplantation and Cellular Therapy (ASTCT), Asia-Pacific Blood and Marrow Transplantation Group (APBMT), Australia and New Zealand Transplant and Cellular Therapies (ANZTCT), Children’s Oncology Group (COG), Cell Therapy Transplant Canada (CTTC), Center for International Blood and Marrow Transplantation Research (CIBMTR), East Mediterranean Blood and Marrow Transplantation Group (EMBMT), European Society for Blood and Marrow Transplantation (EBMT), Latin American Bone Marrow Transplantation Group (LABMT), Pediatric Transplantation and Cellular Therapy Consortium (PTCTC), and Sociedade Brasileira de Transplante de Medula Ossea (SBTMO).
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