International Recommendations for Screening and Preventative Practices for Long-Term Survivors of Transplantation and Cellular Therapy: A 2023 Update
- PMID: 38413247
- PMCID: PMC11181337
- DOI: 10.1016/j.jtct.2023.12.001
International Recommendations for Screening and Preventative Practices for Long-Term Survivors of Transplantation and Cellular Therapy: A 2023 Update
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.
Copyright © 2024 Dr. Seth J Rotz*. Published by Elsevier Inc. All rights reserved.
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 (
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