title: Frequency of abnormal findings detected by comprehensive clinical evaluation at 1 year after allogeneic hematopoietic cell transplantation.
abstract: Consensus guidelines recommend various screening examinations for survivors after allogeneic hematopoietic cell transplantation (HCT), but how often these examinations detect abnormal findings is unknown. We reviewed the medical records of 118 patients who received comprehensive, standardized evaluations at 1 year after allogeneic HCT at Fred Hutchinson Cancer Research Center/Seattle Cancer Care Alliance. Abnormal findings were common, including moderate to severe pulmonary dysfunction (16%), fasting hyperlipidemia (56%), osteopenia (52%), osteoporosis (6%), and active chronic graft-versus-host disease (cGVHD) (64%). Recurrent malignancy (4%) and cGVHD (29%) were detected in previously unsuspected cases. Only 3% of patients had no abnormal findings. We conclude that comprehensive evaluation at 1 year after allogeneic HCT detects a high prevalence of medical problems. Longer follow-up is needed to determine whether early detection and intervention affect later morbidity and mortality.
authors.affiliation: Division of Clinical Research, Fred Hutchinson Cancer Research Center, Seattle, Washington 98109, USA. sjlee@fhcrc.org
authors.forename: Stephanie J
authors.initials: SJ
authors.lastname: Lee
authors.forename: Travis
authors.initials: T
authors.lastname: Seaborn
authors.forename: Frances J
authors.initials: FJ
authors.lastname: Mao
authors.forename: Susan C
authors.initials: SC
authors.lastname: Massey
authors.forename: Ngoc Q
authors.initials: NQ
authors.lastname: Luu
authors.forename: Mary A
authors.initials: MA
authors.lastname: Schubert
authors.forename: Jason W
authors.initials: JW
authors.lastname: Chien
authors.forename: Paul A
authors.initials: PA
authors.lastname: Carpenter
authors.forename: Carina
authors.initials: C
authors.lastname: Moravec
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Martin
authors.forename: Mary E D
authors.initials: ME
authors.lastname: Flowers
mesh_terms: D000328:Adult; D005215:Fasting; D005260:Female; D005500:Follow-Up Studies; D006086:Graft vs Host Disease / Q000401:mortality* / Q000473:pathology; D017408:Guidelines as Topic; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D006949:Hyperlipidemias / Q000401:mortality* / Q000473:pathology; D008171:Lung Diseases / Q000209:etiology / Q000401:mortality* / Q000473:pathology; D008297:Male; D010024:Osteoporosis / Q000401:mortality* / Q000473:pathology; D015995:Prevalence; D013997:Time Factors; D014184:Transplantation, Homologous