Frequency of abnormal findings detected by comprehensive clinical evaluation at 1 year after allogeneic hematopoietic cell transplantation.
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.
Lee
Stephanie J
SJ
Division of Clinical Research, Fred Hutchinson Cancer Research Center, Seattle, Washington 98109, USA. sjlee@fhcrc.org
Seaborn
Travis
T
Mao
Frances J
FJ
Massey
Susan C
SC
Luu
Ngoc Q
NQ
Schubert
Mary A
MA
Chien
Jason W
JW
Carpenter
Paul A
PA
Moravec
Carina
C
Martin
Paul J
PJ
Flowers
Mary E D
ME
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