Related Experiment Video
Updated: Apr 15, 2026
Isolation Method for Long-Term and Short-Term Hematopoietic Stem Cells
Published on: May 19, 2023
Long-term follow-up after allogeneic stem cell transplantation
Inken Hilgendorf1, Hildegard Greinix, Jörg P Halter
1Clinic of Internal Medicine II, University Hospital Jena, University Clinic of Internal Medicine I, Medical University of Vienna, Austria, Department of Hematology, University Hospital of Basel, St. Anna Children's Hospital, Vienna, Austria, Department of Hematology, Oncology, and Stem-Cell Transplantation, Medical Center - University of Freiburg, Department of Internal Medicine III, University Hospital Regensburg.
Insights
Allogeneic hematopoietic stem-cell transplantation (allo-HSCT) survivors face significant long-term risks, including chronic graft-versus-host disease and reduced life expectancy. Proactive, individualized follow-up care is crucial for managing these complications.
Area of Science:
- Hematology
- Transplantation Medicine
- Oncology
Background:
- Allogeneic hematopoietic stem-cell transplantation (allo-HSCT) is a life-saving procedure performed on over 3000 individuals annually in Germany.
- While allo-HSCT survival rates have improved, long-term complications significantly impact patient quality of life.
Purpose of the Study:
- To review the long-term sequelae of allogeneic hematopoietic stem-cell transplantation (allo-HSCT).
- To highlight the prevalence and impact of chronic complications following allo-HSCT.
Main Methods:
- Literature review of pertinent articles from PubMed.
- Inclusion of current international guidelines.
- Exclusion of case reports.
Main Results:
- High incidence of chronic graft-versus-host disease (cGVHD) (50-70% within 10 years).
- Increased risk of infections, gonadal dysfunction (up to 99%), liver dysfunction, and metabolic disturbances (40-50%).
- Reduced life expectancy compared to the general population.
Conclusions:
- Preventive measures and individualized, multidisciplinary follow-up care are essential for allo-HSCT survivors.
- Prospective clinical trials and standardized data registries are needed to improve long-term care and understanding of allo-HSCT sequelae.
Background:
Over 3000 persons undergo allogeneic hematopoietic stem-cell transplantation (allo-HSCT) in Germany every year. Advances in allo-HSCT have prolonged the survival of treated patients but have concomitantly increased the risk of long-term complications that impair their quality of life.
Methods:
This literature review of the long-term sequelae of allo-HSCT is based on pertinent articles that were retrieved by a selective search of PubMed, and on current international guidelines. Case reports were excluded from consideration.
Results:
Hardly any randomized clinical trials have been performed to investigate the long-term outcome of allo-HSCT, but international consensus-based guidelines have been published. 50% to 70% of patients treated with allo-HSCT develop chronic graft-versus-host disease (cGVHD) within ten years of treatment. Transplant recipients are at higher risk of infection, including the reactivation of dormant herpes viruses; therefore, vaccination is recommended, as described in the current guidelines. Gonadal dysfunction arises in up to 92% of men and up to 99% of women; its frequency depends on the timing of transplantation, on radiotherapy, and on other factors. The medications that transplant recipients need to take can impair liver function, and transfusionassociated hemosiderosis can do so as well. 40% to 50% of patients suffer from lipid metabolic disturbances that increase the risk of myocardial infarction, peripheral arterial occlusive disease, and stroke. Their life expectancy is shorter than that of the overall population.
Conclusion:
Measures should be taken to prevent the potential long-term complications of allo-HSCT. All patients who have been treated with allo-HSCT should receive individualized, risk-adapted, and multidisciplinary follow-up care, so that any complications that arise can be correctly diagnosed and appropriately treated. Long-term follow-up care could be improved by prospective clinical trials investigating the long-term sequelae of allo-HSCT, as well as by consistent, uniform documentation of these sequelae in supraregional data registries.
Related Concept Videos
01:22Bone Marrow Sampling and Transplants
The transplant begins with high doses of chemotherapy and radiation treatment, which aim to destroy...
01:21Stem Cell Therapy for Tissue Regeneration
Types of Stem Cells used in Stem Cell Therapy
The two main cell...
01:19Multipotency of Hematopoietic Stem Cells