Оглавление
Группа авторов. Blood and Marrow Transplantation Long Term Management
Table of Contents
List of Tables
List of Illustrations
Guide
Pages
Blood and Marrow Transplantation Long Term Management. Survivorship after Transplant
Foreword to the Second Edition
Foreword (from first edition)
List of Contributors
CHAPTER 1 Introduction to long‐term survivorship after hematopoietic cell transplantation
Background
Rapidly rising numbers of long‐term transplant survivors
Long‐term issues in long‐term survivors
Developing resources and a guide for long‐term survivors
Declaration of commercial interest
References
CHAPTER 2 International Blood and Marrow Registries: trends on long‐term data collection
Overview of the Role of Registries in HCT
Overview of Late Effects Data Collection through Registries. Registry Strengths
Registry Challenges
Future of Data Collection in Survivorship
Center for International Blood and Marrow Transplant Research (CIBMTR)
Introduction to the registry
Data collection
Late effects specific data collection
Future plans
The Registry of the European Society for Blood and Marrow Transplantation (EBMT)
Introduction to the registry
Data collection
Late effects specific data collection
Future plans
Asia‐Pacific Blood and Marrow Transplant Group (APBMT)
Introduction of the registry
Data collection
Late effects specific data collection
Future plans
The Registry of the Eastern Mediterranean Blood and Marrow Transplantation Group (EMBMT)
Introduction to the registry
Data collection
Late Effects Specific Data Collection
Future plans
References
CHAPTER 3 Long‐term follow‐up program and transplant clinic setup
Introduction
Concept of long‐term survivorship
Late effects after HSCT
Timing and transition to long‐term survivorship care
The transition from pediatric to adult long‐term care
Long‐term follow‐up program
Long‐term follow‐up Clinic
Long‐term transplant team and the annual LTFU visit
Preparation of the visit
The LTFU visit
Post‐visit follow‐up
Recommendation for screening and preventive practices
Organizing a long‐term follow‐up clinic in resource‐limited countries
Essential need for a LTFU clinic in resource limited countries
Unique challenges for survivorship in the resource limited countries
References
CHAPTER 4 Telemedicine in patient care of long‐term transplant survivors
Introduction
Principles of telehealth. Components of Telehealth
Practical applications for Telehealth
Legal, ethical and regulatory considerations for Telehealth
Reimbursement and financial considerations for Telehealth
Challenges to Telehealth adoption
What we know about current models for hct survivorship
Example of a LTFU telemedicine model
Future directions
References
CHAPTER 5 Long‐term follow‐up calendar
Introduction
Survivorship care plan
Schedule of the long‐term follow‐up visit
Screening and preventive recommendations
References
CHAPTER 6 Late effects post‐allogeneic hematopoietic stem cell transplantation
Introduction
Identification of late effects
Late effects. Acute and chronic infections
Cutaneous complications
Oral/dental complications
Hepatic complications
Gastrointestinal complications
Genital complications
Renal complications
Ocular complications
Endocrine complications
Hypogonadism, fertility loss, pregnancy, and lactation issues
Musculoskeletal and bone complications
Pulmonary complications
Neurologic complications
Psychological and social complications
Sexual dysfunction
Subsequent hematologic malignancies
Very late effects. Cardiovascular complications
Subsequent neoplasms
Future directions
Summary
References
CHAPTER 7 Late effects post‐autologous hematopoietic stem cell transplantation
Introduction
Pulmonary Complications
Cardiovascular Complications
Secondary Malignancies
Endocrine and Metabolic Complications. Thyroid Dysfunction
Bone Complications
Gonadal Dysfunction
Kidney Complications
Infectious Complications
Quality of Life and Psychosocial Effects
Cognitive Dysfunction
Special Considerations in Lymphoma and Myeloma
Conclusion
References
CHAPTER 8 Long‐term follow‐up of children
Introduction
Common posttransplant screening and prevention guidelines
Engraftment
Iron overload
Chronic GVHD
Infection and immunity
Ocular
Oral/dental
Pulmonary
Cardiovascular or metabolic
Gastrointestinal or hepatic
Renal or genitourinary
Muscle or connective tissue
Bone
Skin
Endocrinopathies
Growth Hormone deficiency
Hypogonadism, pubertal delay and infertility
Thyroid dysfunction
Iatrogenic Cushing’s Syndrome and Adrenal insufficiency
Insulin Resistance and Diabetes Mellitus
Neurocognitive
Psychological and quality of life
Subsequent neoplasms (SMN)
Survivorship care plans
References
CHAPTER 9 Graft‐versus‐host disease and late effects after hematopoietic stem cell transplantation
Introduction
cGVHD and nonmalignant late effects. Ocular effects [18]
Pulmonary effects [29,30]
Restrictive lung disease
Chronic obstructive lung disease
Complications of bones and joints [36] Avascular necrosis of bone (AVN)
Osteoporosis
Late cardiovascular complications [48]
Secondary Malignancies
Secondary leukemia after allogeneic HSCT
Lymphomas
Solid Tumors[53]
Pathogenesis
Skin and mucosal carcinoma and cGVHD
Thyroid carcinoma and cGVHD
References
CHAPTER 10 Screening and prevention guidelines for hematopoietic cell transplant survivors
Introduction
Published guidelines for screening and prevention of late complications in hsct survivors
Non‐infectious late effects. Neurocognitive
Eye
Oral and dental
Respiratory
Cardiovascular and metabolic
Gastrointestinal and liver
Renal and genitourinary
Musculoskeletal and connective tissue
Bone
Gonadotoxicity and fertility
Endocrine
Skin
Psychological complications and quality of life
Infectious and immunologic
Subsequent neoplasms
Treatment summary and survivorship care plans
Areas for future research
References
CHAPTER 11 Biology of survivorship after blood or marrow transplantation
Introduction
Anthracycline‐related heart failure
Genetics of heart failure
Therapy‐related myeloid neoplasia
Pathogenesis of t‐MDS/AML
Germline Polymorphisms
Candidate genes
Gene‐gene interactions
Genome‐wide association studies (GWAS)
Differential Gene Expression Profiles
Clonal Hematopoiesis with Somatic Mutations detected by DNA Sequencing
Cognitive outcomes
Genetic susceptibility to cognitive impairment
Conclusions
References
CHAPTER 12 Second malignancies
Introduction
Estimating the risk of second cancers
Pathophysiology
Risk factors for secondary malignancies. MDS & AML
Lymphoma
Solid tumors. Single center studies
Collaborative studies
Analysis on specific tumor types. Skin cancers
Liver cancers
Thyroid cancers
Breast cancers
Diagnosis, screening and prevention
Management; Treatment and Recommendations
References
CHAPTER 13 Anti‐infective prophylaxis, immunization and prevention of late infectious complications
Introduction
Vaccination
Antimicrobial prophylaxis
Immunoglobulin
Prevention of bacterial infections. Pneumococci
Haemophilus influenzae type B (HIB)
Meningococci
Other bacterial infections
Prevention of viral infections. Varicella‐zoster virus
CMV
Influenza
Papilloma virus
Hepatitis B virus
Hepatitis C virus
Hepatitis E virus
Prevention of fungal infections
Travel medicine
References
CHAPTER 14 Seasonal respiratory viral infections
Introduction
Community Respiratory Virus Infections in HCT Recipients. Influenza
2009 H1N1
Respiratory Syncytial Virus infections
Human Parainfluenza Virus
Human Metapneumovirus
Human Coronavirus
Human Rhinovirus
Other CRVs
Respiratory viruses and alloimmune lung syndrome
Diagnostic Evaluation
Treatment Options
Influenza
RSV
HPIV
Other CRVs
Preventing exposure
Infection Control Practices in the hospital, clinic and at home
Preventing Disease and Progression to LRTI
Influenza Vaccination
Chemoprophylaxis and Pre‐emptive Therapy
Future Considerations
References
CHAPTER 15 Monitoring and management of hepatitis B, C, and HIV infection before and after transplantation
Hepatitis B Virus (HBV) HBV screening
Patient and donor HBV status at HCT and risk of complications
Antiviral therapy/prophylaxis
Monitoring HBV after HCT [22]
Vaccination
Summary of HBV and HCT
Hepatitis C Virus (HCV)
HCV screening
Patients with HCV infection and risk of complications after HCT
Donor with HCV infection and risk of complications
Antiviral treatment (ASBMT Taskforce recommendations) [27]
Monitoring after HCT
Summary of HCV and HCT
Human Immunodeficiency Virus (HIV)
HIV Screening
Patients with HIV at HCT and risk of complications
Monitoring HIV patients during HCT
Acknowledgment
References
CHAPTER 16 Skin chronic GVHD
Introduction
cGVHD pathophyisiology
Animal models
Generation of specific T‐cell clones
T regs impairment and aberrant B‐cells activity
Fibrotic damage and tissue remodeling
Biomarkers
Pathological findings in cutaneous cGVHD
Clinical manifestations
Clinical management. Diagnosis
Scoring
Imaging and instrumental tools in skin cGVHD
Systemic treatment
Ancillary and topical treatment
Topical steroids
Topical calcineurin inhibitors
Phototherapy. PUVA
Other treatments
References
CHAPTER 17 Ocular complications
Introduction
Ocular graft‐versus‐host disease
Pathophysiology
Diagnosis
Incidence
Risk factors
Screening and prevention
Treatment
Cataract formation
Pathophysiology
Frequency and risk factors
Screening, prevention and management
Other non‐GVHD ocular complications. Ocular infections. Incidence and risk factors
Screening, prevention, and treatment
Ischemic microvascular retinopathy (IMR) Incidence and risk factors
Screening, prevention and treatment
Recommendations for the survivors / general practitioner
References
CHAPTER 18 Management of oral and dental complications
Introduction
Xerostomia and salivary gland hypofunction
Management of xerostomia
Oral graft‐versus‐host disease
Management of oral cGVHD
Jaw/bisphosphonate osteonecrosis
Secondary malignancies
Management
Conclusions
References
CHAPTER 19 Thyroid disease: monitoring and management guidelines
Introduction
Hypothyroidism. Pathophysiology
Frequency/ Cumulative Incidence
Risk Factors
Surveillance/ Screening
Treatment
Recommendation for Survivors
Hyperthyroidism. Pathophysiology
Frequency/ Cumulative Incidence
Risk Factors
Surveillance/ Screening
Treatment
Recommendation for Survivors
Thyroid nodules. Pathophysiology
Frequency/ Cumulative Incidence
Risk Factors
Surveillance/ Screening
Treatment
Recommendation for Survivors
Thyroid disorders and pregnancy post‐HSCT
References
CHAPTER 20 Pretransplant considerations in gender, reproductive, and sexual health
Introduction
General principles
Females: Ovarian physiology and potential for primary ovarian insufficiency and failure
Ovarian protection during HSCT
Fertility preservation
Contraception in men
Menstrual suppression and contraception for women
Pre‐HSCT cervical cytology and HPV disease
Pre‐HSCT STI screening and prevention
Sexuality
Summary
References
CHAPTER 21 Posttransplant Considerations in Gender, Reproductive, and Sexual Health
Introduction
Genital chronic graft‐versus‐host disease
Sex‐specific Signs and Symptoms of Genital GVHD. Females
Girls and young female adolescents
Males
Diagnosis and Staging
Management
Females
Males
Chronic GVHD and Sexual Dysfunction
Hypogonadism. General Considerations for females
Non‐gynecologic consequences of POI
Hormonal treatment of POI: general considerations
Hormonal therapy versus hormonal contraception
Contraceptive alternatives other than oral hormones post‐HSCT
Hypogonadism in Males
Special considerations for children and adolescents. POI for prepubertal girls and puberty induction
Pediatric and Adolescent Gynecologic Examination
Reproductive Health Visit, Consent, Confidentiality for female adolescents
Post‐HSCT HPV, cervical cancer and breast cancer prevention
Sexuality and fertility post‐HSCT
Summary
References
CHAPTER 22 Fertility issues, fertility preservation, and pregnancy outcome in long‐term survivors
Female fertility after HSCT
Fertility preservation options
Male fertility after HSCT
Fertility preservation options
Pregnancy after HSCT. Prevalence of conception and pregnancy
Outcome of pregnancy
Frequency of pregnancy after assisted conception in HSCT
Pregnancy outcome after assisted conception in HSCT
Maternal health during pregnancy following HSCT
Fertility Prevention Counseling
References
CHAPTER 23 Sexual Dysfunction in Long‐Term Survivors
Introduction
Sexual Well‐Being and Sexual Distress
Sexual Dysfunction
Sexual Arousal Disorder
Orgasmic Dysfunction
Dyspareunia
Risk Factors. Treatment‐Related Effects
Conditioning regimens
Chronic genital GVHD
Cardiovascular disease
Hormonal disorders
Medications
Psychosocial Distress
Body image distress
Screening and Prevention
Treatment
Addressing Psychosocial Factors. Cognitive Behavioral Therapy
Integrative sex therapy approaches
Couples therapy
Pharmacologic Interventions
Topical therapy
Systemic therapy
Other Methods
Considerations for Sexual Minority Populations
Recommendations for Practitioners Regarding SM Patients
Recommendations for Practitioners. Managing Polypharmacy
Routine Assessment of Sexual Functioning
Recommendations for Survivors
References
CHAPTER 24 Late non‐infectious pulmonary complications
Introduction
Early Non‐infectious Pulmonary Complications
Bronchiolitis Obliterans Syndrome
Cryptogenic Organizing Pneumonia
Interstitial Lung Disease:
Thoracic Air Leak Syndrome
Pulmonary Drug Toxicity
Pleural effusions
Venous Thromboembolic Disease (VTE)
Pulmonary Hypertension
Posttransplant Lymphoproliferative Disorder (PTLD)
Diagnostic considerations of non‐infectious pulmonary complications following HSCT
Conclusion
References
CHAPTER 25 Cardiac and arterial complications
Late cardiac dysfunction
Cardiotoxicity in cancer survivors
Congestive heart failure and cardiomyopathy. Incidence
Risk factors for congestive heart failure
Other cardiac complications
Screening, monitoring and management of cardiac dysfunction
Arterial disease
Arterial disease after HSCT
Risk factors for arterial disease
Pathogenesis of arterial disease after HSCT
Endocrine dysfunction
Endothelial injury and other factors
Screening and preventive recommendations for survivors at risk for arterial disease
Patients at risk for arterial disease
Type and timing of screening
Prevention and treatment of cardiovascular risks
Disclosures
References
CHAPTER 26 Cardiovascular risk factors
Introduction
Dyslipidemia
Pathophysiology
Estimated incidence
Screening, Prevention and Treatment
Hypertension
Pathophysiology
Estimated incidence
Screening, Prevention and Treatment
Diabetes
Pathophysiology
Estimated incidence
Screening, Prevention and Treatment
Other Endocrinopathies
Hypothyroidism
Growth hormone deficiency
Gonadal failure
Metabolic syndrome
Pathophysiology
Estimated incidence
Sarcopenic obesity
Screening, Prevention and Treatment
Summary
References
CHAPTER 27 Gastrointestinal complications
Introduction
Pre‐existing gastrointestinal conditions
Preconditioning‐related GI complications
Acute and subacute complications. Oral pain. Conditioning‐induced mucositis
Oral infections
Dysphagia and odynophagia
Nausea, vomiting, and diarrhea. Chemotherapy effects
aGVHD. Background
Symptoms
Biomarkers
Endoscopy
Histology
Radiology
Infection
Management
Abdominal pain. Neutropenic enterocolitis
Posttransplant lymphoproliferative disease
GI bleeding
Chronic complications. Introduction
Oral complications
Esophageal complications
Nausea, vomiting, abdominal pain, diarrhea
Late acute GI GVHD
Overlap cGVHD
Chronic GI GVHD
Infections
Medication adverse events
Pancreaticobiliary disease
Future directions
Financial support
Disclosures
References
CHAPTER 28 Hepatic Complications
Introduction
Initial evaluation
Iron overload. Background
Diagnosis
Management
Chronic hepatic graft‐versus‐host disease (GVHD) Background
Diagnosis
Management
Chronic hepatitis B (HBV) Background
Diagnosis
Management
Chronic hepatitis C (HCV) Background
Diagnosis
Management
Chronic hepatitis E (HEV) Background
Diagnosis
Management
Non‐alcoholic fatty liver disease (NAFLD) Background
Diagnosis
Management
Focal nodular hyperplasia (FNH) Background
Diagnosis
Management
Nodular regenerative hyperplasia (NRH) Background
Diagnosis
Management
Cirrhosis. Background
Diagnosis
Management
Hepatocellular carcinoma (HCC) Background
Diagnosis
Management
References
CHAPTER 29 Renal complications
Introduction
Acute kidney injury
Chronic kidney disease
Pathophysiology
Thrombotic microangiopathy
Proteinuria
Podocytopathy
Bk nephropathy
End stage renal disease
Strategies to prevent and mitigate kidney injury post HSCT
References
CHAPTER 30 Posttransplantation bone disease: prevalence, surveillance, prevention, and management
Introduction
Low Bone Mineral Density, Osteopenia and Osteoporosis. Pathophysiology
Radiation Therapy
Chemotherapy
Glucocorticoids
Calcineurin Inhibitors
Frequency/Cumulative Incidence
Risk Factors
Surveillance/Screening
Prevention
Treatment
Treatment Considerations in Children and Adolescents
Other Agents
Parathyroid hormone‐derived peptides
Selective Estrogen Receptor Modulators
RANK Ligand (RANKL) Inhibitors
Recommendation for the Survivor/General Practitioner
Avascular Necrosis. Pathophysiology
Frequency/Incidence
Risk Factors
Screening/Surveillance
Prevention
Treatment
Vascularized fibular graft (VFG)
Osteotomy
Recommendations for the Survivor and General Practitioner
References
CHAPTER 31 Late neurologic complications
Introduction
Pathophysiology
Frequency/cumulative incidence
Risk Factors
Clinical Entities. Infections
Cerebrovascular disease
Immune‐mediated disorders
Neurocognitive dysfunctions
Secondary CNS tumors
CNS disease relapse
Surveillance/ screening
Prevention
Recommendation for the survivors / general practitioner
References
CHAPTER 32 Neurocognitive dysfunction
Introduction
Definition and critical domains of neurocognitive dysfunction
Risk factors and correlates
Primary Disease
Conditioning Regimen
GVHD Prophylaxis and Immunosuppressive Therapies
Infections
Other Risk Factors and Correlates
Biomarkers as potential mechanisms
Biomarkers of CNS injury and neuroinflammation
Neuroimaging biomarkers
Neurocognitive dysfunction in adult patients with HCT
Presentation prior to HCT
Presentation throughout the course of HCT
Relevance of Neurocognitive Dysfunction
Neurocognitive dysfunction in special populations
Children
Youngest and Adolescent Young Adult (AYA) HCT Survivors
Older Adults
Assessment. General Recommendations
Test Measures
Self‐Report Measures and Clinical Interview
Recommendations regarding adult HCT survivors
Recommendations regarding pediatric HCT survivors
Interventions
Interventions to minimize therapy‐related neurocognitive toxicity
Management of acute CNS toxicities
Non‐pharmacologic interventions
Pharmacologic Interventions
Concluding remarks
References
CHAPTER 33 Psychological Distress
Introduction
Late survivorship
Screening for distress
Treatment
Pharmacological interventions
Non pharmacological interventions
Recommendations for the survivors/general practitioner
References
CHAPTER 34 Evaluation and management of fatigue in survivors of allogeneic hematopoietic stem cell transplantation
Introduction
Pathophysiology of Fatigue in HSCT Survivors
Frequency and Cumulative Incidence
Risk Factors
Screening and Evaluation
Pharmacologic and Non‐Pharmacologic Treatments for Fatigue
Pharmacologic interventions
Non‐pharmacologic interventions. Exercise, Physical Activity, and Structured Rehabilitation
Management of Concurrent Symptoms
Psychoeducational Interventions
Interventions to Improve Sleep Quality and Circadian Rhythmicity
Complementary and integrative therapies
Survivor Self‐Management Recommendations
Recommendations for Primary Care
Summary
References
CHAPTER 35 Social Issues
Introduction
Social Factors Associated with HCT Access and Outcomes. Socioeconomic and Sociodemographic Factors
Educational Status and Health Literacy
Geographical Factors
Caregiver Availability
Insurance Status
Influence of HCT on Social Well‐being. Financial Burden
Return to Previous Social Roles
Family Relationships
Relationship Between Social and Psychological Factors
Instruments to Assess Social Risks
Conclusion
References
CHAPTER 36 Health‐related quality of life in adult and pediatric survivors
Introduction
Quality of life
Clinical Features of Treatment with Allogeneic HSCT
Health‐related Quality of Life. Adults
Pediatrics
Physical Function. Adults
Pediatrics
Psychological function. Adult
Pediatric
Parental psychological function
Social and role functioning. Adults
Pediatrics
Benefit‐finding and post‐traumatic growth
Healthy lifestyle and health‐promoting behaviors
Application to practice. Adults
Pediatrics
Interventions. Adults
Pediatrics
Summary
References
CHAPTER 37 Immunosuppressive agents and monitoring in long‐term survivors
GVHD Prophylaxis Agents:
Calcineurin Inhibitors
Mycophenolate Mofetil
Sirolimus
Cyclophosphamide
Antithymocyte globulin
GVHD Treatment Agents
Corticosteroids
Ruxolitinib
Ibrutinib
Imatinib
Monoclonal Antibodies. Alemtuzumab
Tumor necrosis factor (TNF)‐α blockade
Rituximab
Basiliximab
References
CHAPTER 38 Nutritional support and nutritional supplementation
Introduction (Definition; subgroups)
Pathophysiology
Frequency/cumulative incidence
Risk factors
Surveillance/ screening
Prevention
Treatment
Recommendation for the survivors / general practitioner
References
CHAPTER 39 Daily routines and healthy lifestyle guidelines
Background
Education
Exercise
Diet
Physical safety and substances
Infection Prevention
Compliance with Scheduled Follow Up
Health Maintenance Screenings
Community/Home Support
Summary
References
CHAPTER 40 Prevalent psychosocial adjustment issues and solutions: lifestyle and social challenges
Introduction
The patient and their support system: coping with stress in the long‐term care setting
The patient and caregiver: facing intimacy issues
Other quality of life issues for the stem‐cell transplant patient
Conclusion
References
CHAPTER 41 Complementary and alternative medicine in HSCT
Introduction
Natural products in HCT recipients
Mind and body practices in HCT recipients
Mindfulness meditation, psychoeducation, and relaxation
Acupunctures and massage therapy
Music therapy and Art interventions
Other complementary and alternative medicine
Safety of complementary and alternative medicine
Approach to CAM discussions
Future directions
References
CHAPTER 42 Impact of adherence in outcome of long‐term survivors
Introduction. Case of unintentional non‐adherence
Case of intentional non‐adherence
Adherence
Non‐Adherence
Non‐intentional and intentional non‐adherence
HSCT a risk factor for non‐adherence
Recommendation for healthcare providers
How to assess and monitor adherence/incorporate adherence in daily care?
How to support survivors?
Future research
Conclusion
References
CHAPTER 43 Prominent role of allied health professionals
Introduction
Immunizations
First visit
Subsequent first‐year visits
Annual visits
References
CHAPTER 44 Patient reported outcomes
Introduction
Basic concepts about PROs
Perceived health status
Physical function and symptom burden post‐HCT
Psychological aspects post‐HCT
Social aspects post‐HCT
Behavioral aspects post‐HCT
PROs and GVHD
PROs as predictors of HCT survival
Conclusion
References
CHAPTER 45 Caregivers of long‐term survivors
Introduction
Frequency/cumulative incidence
Risk factors
Surveillance/ screening
Recommendation for the survivors/caregivers/general practitioner
References
CHAPTER 46 Patient’s perspective: memoir of a recovered lymphomaniac
Lilian
Living a normal Life
Hello Cancer
So, here we go!
Staging the Cancer
Staging and Sarah Cannon
Clinical Trials
Lymphomaniac
Remission
PET Scan and What's Next?
Vanderbilt Hematology and Stem Cell Clinic
Transplant Day
Now for the Fun Part: Four Months of Treatment
Going Home
Returning to Everyday Life
Twenty‐Three and Me / Ancestory.Com
Medical Surprises and Life for the past 10 Years
Blood Clots
More Post‐Transplant Medical Surprises
Colonoscopy
Colon Cancer Surgery
Tumor Board
Wake Up Call
Radiation Treatments
The Puppy from Hell
The Move to Florida
The last of the Cancer‐Related Episodes
The Continuation of the Story but not the End
So Much to be Thankful For
APPENDIX 1 Commonly used transplant‐related medications in long‐term survivors
References
APPENDIX 2 The eGVHD App
References
Index. A
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