title: What do we need to know about allogeneic hematopoietic stem cell transplant survivors?
abstract: Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a potentially curative treatment for over 70 benign and malignant hematologic and immunological processes. Over the past several decades, significant technological and post-transplant supportive advances have been made, resulting in a decrease in early transplant mortality and continued growth in the population of allo-HSCT survivors. With the expansion in the number of long-term survivors, as well as of those considering a transplant, the focus of transplant medicine has been shifted significantly to include a more prominent role for the care of the 'long-term' survivor. These patients have survived the acute critical phase of transplantation and have potentially achieved remission from their primary disease, yet allo-HSCT patients do not return to pre-transplant health status. For survivors >2 years removed, the time of transplant all-cause mortality is four- to nine-fold higher than age-matched peers within the general population. These patients represent a distinct, high-risk population that must be monitored for long-term transplant complications, including chronic GvHD (cGvHD), multi-organ dysfunctions and secondary malignancies. This article will review in a non-exhaustive manner, the approach to long-term care of an allo-HSCT recipient.
authors.affiliation: Department of Internal Medicine, Hematology and Stem Cell Transplant Section, Vanderbilt University Medical Center, Nashville, TN, USA.
authors.forename: C A
authors.initials: CA
authors.lastname: Clark
authors.affiliation: The University of Tennessee Heath Science Center, College of Medicine, Memphis, TN, USA.
authors.forename: M
authors.initials: M
authors.lastname: Savani
authors.affiliation: Department of Haematology, Saint Antoine Hospital, Paris, France.|INSERMUMR 938, Paris, France.|Université Pierre et Marie Curie, Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Mohty
authors.affiliation: Department of Internal Medicine, Hematology and Stem Cell Transplant Section, Vanderbilt University Medical Center, Nashville, TN, USA.
authors.forename: B N
authors.initials: BN
authors.lastname: Savani
mesh_terms: D003266:Continuity of Patient Care; D006086:Graft vs Host Disease; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects* / Q000401:mortality; D006801:Humans; D009026:Mortality; D009102:Multiple Organ Failure; D016609:Neoplasms, Second Primary; D017741:Survivors; D014184:Transplantation, Homologous