International recommendations for screening and preventative practices for long-term survivors of transplantation and cellular therapy: a 2023 update

Seth J Rotz^#^{1

2}, Neel S Bhatt^#³, Betty K Hamilton⁴, Christine Duncan⁵, Mahmoud Aljurf⁶, Yoshiko Atsuta^{7

8}, Kristen Beebe⁹, David Buchbinder¹⁰, Peggy Burkhard¹¹, Paul A Carpenter³, Naeem Chaudhri⁶, Mohamed Elemary¹², Mahmoud Elsawy^{13

14}, Gregory M T Guilcher¹⁵, Nada Hamad^{16

17

18}, Amado Karduss¹⁹, Zinaida Peric²⁰, Duncan Purtill^{21

22}, Douglas Rizzo^{23

24}, Morgani Rodrigues²⁵, Maria Belén Rosales Ostriz²⁶, Nina Salooja²⁷, Helene Schoemans^{28

29}, Adriana Seber³⁰, Akshay Sharma³¹, Alok Srivastava³², Susan K Stewart³³, K Scott Baker³, Navneet S Majhail³⁴, Rachel Phelan^{24

35}

Affiliations

¹ Division of Pediatric Hematology, Oncology, and Blood and Marrow Transplantation, Pediatric Institute, Cleveland Clinic Foundation, Cleveland, OH, USA. rotzs@ccf.org.
² Blood and Marrow Transplant Program, Department of Hematology and Oncology, Taussig Cancer Institute, Cleveland Clinic Foundation, Cleveland, OH, USA. rotzs@ccf.org.
³ Fred Hutchinson Cancer Center, Seattle, WA, USA.
⁴ Blood and Marrow Transplant Program, Department of Hematology and Oncology, Taussig Cancer Institute, Cleveland Clinic Foundation, Cleveland, OH, USA.
⁵ Dana Farber/Boston Children's Cancer and Blood Disorders Center, Harvard University, Boston, MA, USA.
⁶ King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia.
⁷ Department of Registry Science for Transplant and Cellular Therapy, Aichi Medical University School of Medicine, Nagakute, Japan.
⁸ Japanese Data Center for Hematopoietic Cell Transplantation, Nagakute, Japan.
⁹ Phoenix Children's Hospital and Mayo Clinic Arizona, Phoenix, AZ, USA.
¹⁰ Division of Hematology, Children's Hospital of Orange County, Orange, CA, USA.
¹¹ National Bone Marrow Transplant Link, Southfield, MI, USA.
¹² Hematology and BMT, University of Saskatchewan, Saskatoon, SK, Canada.
¹³ Division of Hematology, Dalhousie University, Halifax, NS, Canada.
¹⁴ QEII Health Sciences Center, Halifax, NS, Canada.
¹⁵ Section of Pediatric Oncology/Transplant and Cellular Therapy, Alberta Children's Hospital, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
¹⁶ Department of Haematology, St Vincent's Hospital Sydney, Sydney, NSW, Australia.
¹⁷ St Vincent's Clinical School Sydney, University of New South Wales, Sydney, NSW, Australia.
¹⁸ School of Medicine Sydney, University of Notre Dame Australia, Sydney, WA, Australia.
¹⁹ Bone Marrow Transplant Program, Clinica las Americas, Medellin, Colombia.
²⁰ BMT Unit, Department of Hematology, University Hospital Centre Zagreb and School of Medicine, University of Zagreb, Zagreb, Croatia.
²¹ Fiona Stanley Hospital, Murdoch, WA, Australia.
²² PathWest Laboratory Medicine, Nedlands, WA, Australia.
²³ Medical College of Wisconsin, Milwaukee, WI, USA.
²⁴ Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.
²⁵ Israelita Albert Einstein Hospital, São Paulo, Brazil.
²⁶ Division of hematology and bone marrow transplantation, Instituto de trasplante y alta complejidad (ITAC), Buenos Aires, Argentina.
²⁷ Centre for Haematology, Imperial College London, London, UK.
²⁸ Department of Hematology, University Hospitals Leuven, Leuven, Belgium.
²⁹ Department of Public Health and Primary Care, ACCENT VV, KU Leuven-University of Leuven, Leuven, Belgium.
³⁰ Hospital Samaritano, Sao Paulo, Brazil.
³¹ Bone Marrow Transplantation and Cellular Therapy, St. Jude Children's Research Hospital, Memphis, TN, USA.
³² Department of Haematology, Christian Medical College, Vellore, India.
³³ Blood & Marrow Transplant Information Network, Highland Park, IL, 60035, USA.
³⁴ Sarah Cannon Transplant and Cellular Therapy Network, Nashville, TN, USA.
³⁵ Division of Pediatric Hematology/Oncology/Blood and Marrow Transplant, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA.

^# Contributed equally.

PMID: 38413823
PMCID: PMC11809468
DOI: 10.1038/s41409-023-02190-2

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. Bone Marrow Transplant. 2024 Jun.

. 2024 Jun;59(6):717-741.

doi: 10.1038/s41409-023-02190-2. Epub 2024 Feb 27.

Authors

Affiliations

¹ Division of Pediatric Hematology, Oncology, and Blood and Marrow Transplantation, Pediatric Institute, Cleveland Clinic Foundation, Cleveland, OH, USA. rotzs@ccf.org.
² Blood and Marrow Transplant Program, Department of Hematology and Oncology, Taussig Cancer Institute, Cleveland Clinic Foundation, Cleveland, OH, USA. rotzs@ccf.org.
³ Fred Hutchinson Cancer Center, Seattle, WA, USA.
⁴ Blood and Marrow Transplant Program, Department of Hematology and Oncology, Taussig Cancer Institute, Cleveland Clinic Foundation, Cleveland, OH, USA.
⁵ Dana Farber/Boston Children's Cancer and Blood Disorders Center, Harvard University, Boston, MA, USA.
⁶ King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia.
⁷ Department of Registry Science for Transplant and Cellular Therapy, Aichi Medical University School of Medicine, Nagakute, Japan.
⁸ Japanese Data Center for Hematopoietic Cell Transplantation, Nagakute, Japan.
⁹ Phoenix Children's Hospital and Mayo Clinic Arizona, Phoenix, AZ, USA.
¹⁰ Division of Hematology, Children's Hospital of Orange County, Orange, CA, USA.
¹¹ National Bone Marrow Transplant Link, Southfield, MI, USA.
¹² Hematology and BMT, University of Saskatchewan, Saskatoon, SK, Canada.
¹³ Division of Hematology, Dalhousie University, Halifax, NS, Canada.
¹⁴ QEII Health Sciences Center, Halifax, NS, Canada.
¹⁵ Section of Pediatric Oncology/Transplant and Cellular Therapy, Alberta Children's Hospital, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
¹⁶ Department of Haematology, St Vincent's Hospital Sydney, Sydney, NSW, Australia.
¹⁷ St Vincent's Clinical School Sydney, University of New South Wales, Sydney, NSW, Australia.
¹⁸ School of Medicine Sydney, University of Notre Dame Australia, Sydney, WA, Australia.
¹⁹ Bone Marrow Transplant Program, Clinica las Americas, Medellin, Colombia.
²⁰ BMT Unit, Department of Hematology, University Hospital Centre Zagreb and School of Medicine, University of Zagreb, Zagreb, Croatia.
²¹ Fiona Stanley Hospital, Murdoch, WA, Australia.
²² PathWest Laboratory Medicine, Nedlands, WA, Australia.
²³ Medical College of Wisconsin, Milwaukee, WI, USA.
²⁴ Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.
²⁵ Israelita Albert Einstein Hospital, São Paulo, Brazil.
²⁶ Division of hematology and bone marrow transplantation, Instituto de trasplante y alta complejidad (ITAC), Buenos Aires, Argentina.
²⁷ Centre for Haematology, Imperial College London, London, UK.
²⁸ Department of Hematology, University Hospitals Leuven, Leuven, Belgium.
²⁹ Department of Public Health and Primary Care, ACCENT VV, KU Leuven-University of Leuven, Leuven, Belgium.
³⁰ Hospital Samaritano, Sao Paulo, Brazil.
³¹ Bone Marrow Transplantation and Cellular Therapy, St. Jude Children's Research Hospital, Memphis, TN, USA.
³² Department of Haematology, Christian Medical College, Vellore, India.
³³ Blood & Marrow Transplant Information Network, Highland Park, IL, 60035, USA.
³⁴ Sarah Cannon Transplant and Cellular Therapy Network, Nashville, TN, USA.
³⁵ Division of Pediatric Hematology/Oncology/Blood and Marrow Transplant, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA.

^# Contributed equally.

PMID: 38413823
PMCID: PMC11809468
DOI: 10.1038/s41409-023-02190-2

Abstract

As hematopoietic cell transplantation (HCT) and cellular therapy expand to new indications and international access improves, the volume of HCT 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 pre-, peri- and post-transplant exposures and other underlying risk-factors. Guidelines for screening and preventive practices for HCT survivors were originally published in 2006 and updated in 2012. To review contemporary literature and update the recommendations while considering the changing practice of HCT and cellular therapy, an international group of experts was again convened. 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 special needs of patients with distinct underlying HCT indications or comorbidities (e.g., 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.

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Conflict of interest statement

COMPETING INTERESTS

The authors report no conflicts of interest relevant to this work. The authors report the following financial relationships. YA: Lecture fee: Otsuka Pharmaceutical Co., Ltd; CHUGAI PHARMACEUTICAL CO., LTD.; Novartis Pharma KK; AbbVie GK; Honorarium: Meiji Seika Pharma Co, Ltd.; Consultant fee: JCR Pharmaceuticals Co., Ltd.; Kyowa Kirin Co., Ltd. GG: Principal Investigator of Project Sickle Cure, a Sickle Cell Transplant Advocacy and Research Alliance Study partially funded by bluebirdbio. I serve on the steering committee of a STAR clinical trial for which Bristol Myers Squibb has provided funding. NM: Consultant for Anthem, Inc; Stock in HCA Healthcare. Rachel Phelan: Bluebirdbio: advisory board. Amgen: research funding. SR: Medical Monitor for Resource for Clinical Investigation in Blood and Marrow Transplantation (RCI BMT). HS: personal fees: Incyte, Janssen, Novartis, Sanofi and from the Belgian Hematological Society (BHS); research grants from Novartis and the BHS. non-financial support from Gilead, Pfizer, the EBMT (European Society for Blood and Marrow transplantation) and the CIBMTR (Center for International Bone Marrow Transplantation Research). AS: consultant fee from Spotlight Therapeutics, Medexus Inc., Vertex Pharmaceuticals, Sangamo Therapeutics and Editas Medicine. Medical Monitor for Resource for Clinical Investigation in Blood and Marrow Transplantation (RCI BMT). Research funding from CRISPR Therapeutics and honoraria from Vindico Medical Education. AS 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

**Fig. 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), Sociedade Brasileira de Transplante de Medula Ossea (SBTMO).

See this image and copyright information in PMC

References

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1. Passweg JR, Baldomero H, Chabannon C, Basak GW, de la Camara R, Corbacioglu S, et al. Hematopoietic cell transplantation and cellular therapy survey of the EBMT: monitoring of activities and trends over 30 years. Bone Marrow Transpl 2021;56:1651–64. - PMC - PubMed
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International recommendations for screening and preventative practices for long-term survivors of transplantation and cellular therapy: a 2023 update

Affiliations

International recommendations for screening and preventative practices for long-term survivors of transplantation and cellular therapy: a 2023 update

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Research Materials