title: Late Effects Surveillance Recommendations among Survivors of Childhood Hematopoietic Cell Transplantation: A Children's Oncology Group Report.
abstract: Hematopoietic cell transplantation (HCT) is an important curative treatment for children with high-risk hematologic malignancies, solid tumors, and, increasingly, nonmalignant diseases. Given improvements in care, there are a growing number of long-term survivors of pediatric HCT. Compared with childhood cancer survivors who did not undergo transplantation, HCT survivors have a substantially increased burden of serious chronic conditions and impairments involving virtually every organ system and overall quality of life. This likely reflects the joint contributions of pretransplantation treatment exposures and organ dysfunction, the transplantation conditioning regimen, and any post-transplantation graft-versus-host disease (GVHD). In response, the Children's Oncology Group (COG) has created long-term follow-up guidelines (www.survivorshipguidelines.org) for survivors of childhood, adolescent, and young adult cancer, including those who were treated with HCT. Guideline task forces, consisting of HCT specialists, other pediatric oncologists, radiation oncologists, organ-specific subspecialists, nurses, social workers, other health care professionals, and patient advocates systematically reviewed the literature with regards to late effects after childhood cancer and HCT since 2002, with the most recent review completed in 2013. For the most recent review cycle, over 800 articles from the medical literature relevant to childhood cancer and HCT survivorship were reviewed, including 586 original research articles. Provided herein is an organ system-based overview that emphasizes the most relevant COG recommendations (with accompanying evidence grade) for the long-term follow-up care of childhood HCT survivors (regardless of current age) based on a rigorous review of the available evidence. These recommendations cover both autologous and allogeneic HCT survivors, those who underwent transplantation for nonmalignant diseases, and those with a history of chronic GVHD.
authors.affiliation: Clinical Research and Public Health Sciences Divisions, Fred Hutchinson Cancer Research Center, Seattle Children's Hospital, University of Washington, Seattle, Washington. Electronic address: ericchow@u.washington.edu.
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Chow
authors.affiliation: Department of Pediatric Hematology, Oncology, and Bone Marrow Transplant, Medical College of Wisconsin, Milwaukee, Wisconsin.
authors.forename: Lynnette
authors.initials: L
authors.lastname: Anderson
authors.affiliation: Clinical Research and Public Health Sciences Divisions, Fred Hutchinson Cancer Research Center, Seattle Children's Hospital, University of Washington, Seattle, Washington.
authors.forename: K Scott
authors.initials: KS
authors.lastname: Baker
authors.affiliation: Institute for Cancer Outcomes and Survivorship, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama.
authors.forename: Smita
authors.initials: S
authors.lastname: Bhatia
authors.affiliation: Departments of Oncology and Paediatrics, Alberta Children's Hospital, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Gregory M T
authors.initials: GM
authors.lastname: Guilcher
authors.affiliation: Department of Dermatology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts.
authors.forename: Jennifer T
authors.initials: JT
authors.lastname: Huang
authors.affiliation: Departments of Oncology and Paediatrics, Alberta Children's Hospital, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Wendy
authors.initials: W
authors.lastname: Pelletier
authors.affiliation: Department of Cancer and Blood Disorders, Children's Hospital and Clinics of Minnesota, Minneapolis, Minnesota.
authors.forename: Joanna L
authors.initials: JL
authors.lastname: Perkins
authors.affiliation: Department of Pediatric Hematology Oncology, Advocate Children's Hospital, Oak Lawn, Illinois.
authors.forename: Linda S
authors.initials: LS
authors.lastname: Rivard
authors.affiliation: Department of Paediatrics, Hospital for Sick Children, Toronto, Ontario, Canada.
authors.forename: Tal
authors.initials: T
authors.lastname: Schechter
authors.affiliation: Division of Stem Cell Transplant and Regenerative Medicine, Lucile Packard Children's Hospital, Stanford University, Stanford, California.
authors.forename: Ami J
authors.initials: AJ
authors.lastname: Shah
authors.affiliation: Department of Population Sciences, City of Hope National Medical Center, Duarte, California.
authors.forename: Karla D
authors.initials: KD
authors.lastname: Wilson
authors.affiliation: Department of Radiation Oncology, Children's Hospital of Los Angeles, University of Southern California, Los Angeles, California.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Wong
authors.affiliation: Department of Pediatrics, Baystate Children's Hospital, Tufts University School of Medicine, Springfield, Massachusetts.
authors.forename: Satkiran S
authors.initials: SS
authors.lastname: Grewal
authors.affiliation: Department of Population Sciences, City of Hope National Medical Center, Duarte, California.
authors.forename: Saro H
authors.initials: SH
authors.lastname: Armenian
authors.affiliation: Department of Pediatrics, Children's Healthcare of Atlanta, Emory University, Atlanta, Georgia.
authors.forename: Lillian R
authors.initials: LR
authors.lastname: Meacham
authors.affiliation: Department of Oncology, St. Jude Children's Research Hospital, University of Tennessee Health Science Center, Memphis, Tennessee.
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Mulrooney
authors.affiliation: Department of Pediatrics, Children's Healthcare of Atlanta, Emory University, Atlanta, Georgia.
authors.forename: Sharon M
authors.initials: SM
authors.lastname: Castellino
mesh_terms: D000293:Adolescent; D000328:Adult; D026683:Advisory Committees; D064591:Allografts; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D005260:Female; D006086:Graft vs Host Disease / Q000401:mortality / Q000517:prevention & control; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000401:mortality* / Q000628:therapy*; D017410:Practice Guidelines as Topic; D012307:Risk Factors; D017741:Survivors; D019172:Transplantation Conditioning / Q000379:methods*
keywords: Childhood; Guideline; Hematopoietic cell transplantation; Late effects; Surveillance; Survivor