Recognizing complications early, while there are more therapeutic options and while treatments are more effective, is critical to the well-being of transplant recipients.
Complications from hematopoietic cell transplantation can develop long after a patient leaves the transplant center and returns to a primary physician. To prevent late complications from increasing morbidity in these post-transplant patients, physicians need to be aware of the specialized care these patients require.
Screening for chronic graft-versus-host disease (GVHD)
Early detection of chronic graft-versus-host disease (GVHD) can help prevent irreversible organ damage, improve survival, and increase the quality of life of transplant recipients.
Chronic GVHD, an immune response of the donor-derived T cells against recipient tissues, occurs in approximately 30-70% of patients receiving an allogeneic transplant. It is a serious, potentially life-threatening post-transplant complication.
However, with ongoing surveillance, judicious management and coordination of care, most cases of chronic GVHD resolve within five years and the median duration of treatment is 2-3 years. Important care principles for treating chronic GVHD include:
- Early detection and definitive diagnosis
- Involvement of multidisciplinary team
- Administration of topical and/or systemic treatment
- Infection prophylaxis and prompt and effective management of infections
- Long-term follow-up to monitor for late sequelae
Post-Transplant Care Guidelines
Post-Transplant Care guidelines are available that include: recommendations for post-transplant screening and preventive practices, screening for chronic graft-versus-host disease (GVHD) and a vaccination schedule.