Digital Surveillance After Allogeneic Hematopoietic Stem Cell Transplantation Guides Therapeutic Interventions to...

Allogeneic hematopoietic stem cell transplantation (HSCT) offers curative potential for many hematological malignancies; however, outcomes may be adversely affected by infections and transplant-associated complications, contributing to non-relapse mortality (NRM). Innovative digital approaches for outpatient surveillance may support earlier detection of complications and thereby help reduce NRM.

We report on a 73 year-old Caucasian patient who underwent allogeneic HSCT for acute myeloid leukemia in complete remission following non-myeloablative conditioning. The patient participated in the interventional study "Cross-sectoral care for patients with hematological diseases following innovative cell therapy" (SPIZ), which evaluates digital surveillance after cellular therapies. SPIZ comprises daily remote monitoring of vital signs, medication adherence, and symptoms using a multimodal approach integrating an eHealth system (patient smartphone app and caregiver monitoring dashboard), home visits, video consultations, and regular case conferences with referring physicians during follow-up. Eight months post-HSCT, during an inpatient stay at an orthopedic rehabilitation center, the patient reported increasing dyspnea and cough via the app. In response, the SPIZ team initiated immediate transfer to the transplant center. Diagnostic work-up revealed pneumonia caused by aspergillus fumigatus and coronavirus, and progression of pre-existing pulmonary graft-versus-host disease (GvHD), confirmed by computed tomography and spiroergometry. Early detection and prompt transfer enabled rapid initiation of antifungal therapy and intensified GvHD management. The patient was discharged with improved general condition and respiratory function, without further septic complications.

Innovative digital surveillance is an effective tool for outpatient monitoring after cellular therapies, facilitating early detection and intervention and potentially reducing NRM, particularly in high-risk patients.