Late complications after hematopoietic stem cell transplantation

Area of Science:

• Hematology
• Oncology
• Immunology

Background:

• Hematopoietic stem cell transplantation (HSCT) is a curative therapy for various hematologic malignancies and non-malignant disorders.
• The number of HSCT survivors is increasing globally, necessitating attention to long-term health outcomes.
• While HSCT improves prognosis, transplant-associated morbidity and mortality can negatively impact survivors.

Purpose of the Study:

• To highlight the emergence and significance of long-term complications following HSCT.
• To emphasize the importance of recognizing late effects that impact survivors' physical, psychological, and social well-being.
• To advocate for improved pretransplant counseling and post-transplant surveillance strategies.

Main Methods:

• Review of existing literature on long-term outcomes and late effects after HSCT.
• Analysis of factors contributing to late effects, including conditioning regimens and graft-versus-host disease.
• Discussion of the evolving nature of late effects over time post-transplantation.

Main Results:

• Long-term survivors of HSCT are susceptible to a range of malignant and non-malignant complications.
• Conditioning regimens, especially total-body irradiation, and graft-versus-host disease are key contributors to late effects.
• New types of late effects can emerge with extended follow-up periods after HSCT.

Conclusions:

• Awareness of long-term effects is essential for optimizing patient care after HSCT.
• Adapted pretransplant counseling is needed to inform patients about potential long-term risks.
• Recommendations for post-transplant screening, prevention, and early treatment are crucial for managing late effects and improving survivors' quality of life.