Long-term complications after hematopoietic cell transplantation

Area of Science:

• Hematology
• Oncology
• Transplantation Medicine
• Survivorship Research

Background:

• The number of hematopoietic cell transplantation (HCT) survivors is growing.
• While survival rates are high for patients in remission 2-5 years post-HCT, they still experience higher mortality than the general population.
• Late complications significantly contribute to long-term morbidity and mortality in HCT survivors.

Purpose of the Study:

• To review common late complications following HCT.
• To discuss models for HCT survivorship care delivery.
• To identify research gaps and priorities in HCT survivorship.

Main Methods:

• Literature review of common late complications in HCT survivors.
• Analysis of current models for survivorship care.
• Identification of areas requiring further research.

Main Results:

• Late effects encompass secondary cancers, organ-specific issues, infections, quality of life impairments, psychosocial challenges, fertility concerns, financial toxicity, and return-to-work/school difficulties.
• A patient-centric, multidisciplinary approach involving transplant centers and community providers is essential.
• Lifelong follow-up using established guidelines for screening and preventive care is recommended.

Conclusions:

• Hematopoietic cell transplantation survivorship requires comprehensive, lifelong management.
• Coordinated care is vital to address the diverse late effects experienced by HCT survivors.
• Further research is needed to optimize survivorship care models and address unmet needs.