SDS post-transplant screening recommendations
| Late effect/organ system . | Disease-specific abnormality . | Recommendations . |
|---|---|---|
| Cancer screening | • Potential risk for future solid tumor | • Close monitoring with lifestyle modifications, eg, avoidance of smoking and excessive alcohol intake • Encourage SPF usage • Encourage regular self-exams and general population cancer screening recommendations • Follow general population screening recommendations • Patients with total-body irradiation or chest RT require screening mammography starting at age 25 or 8 years after radiation exposure (no later than 40 years)1 |
| Skeletal | • Rib cage deformities, scoliosis, short stature | • Bone mineral density evaluation • Growth hormone evaluation • Consultation with orthopedics for bracing/other interventions |
| GI/pancreatic | • Nutritional deficiencies secondary to pancreatic insufficiency | • Pancreatic dysfunction may become subclinical over time but those who are symptomatic may require long-term pancreatic enzyme replacement and close monitoring of stool output, nutrition, and growth |
| Cardiac | • Baseline cardiac dysfunction compounded by regimen-related toxicity | • Baseline echocardiogram and exposure-modified frequency post-HCT; referral to cardiology if abnormalities identified |
| Hepatic | • Potential for hepatic dysfunction | • Close monitoring of liver enzymes |
| Late effect/organ system . | Disease-specific abnormality . | Recommendations . |
|---|---|---|
| Cancer screening | • Potential risk for future solid tumor | • Close monitoring with lifestyle modifications, eg, avoidance of smoking and excessive alcohol intake • Encourage SPF usage • Encourage regular self-exams and general population cancer screening recommendations • Follow general population screening recommendations • Patients with total-body irradiation or chest RT require screening mammography starting at age 25 or 8 years after radiation exposure (no later than 40 years)1 |
| Skeletal | • Rib cage deformities, scoliosis, short stature | • Bone mineral density evaluation • Growth hormone evaluation • Consultation with orthopedics for bracing/other interventions |
| GI/pancreatic | • Nutritional deficiencies secondary to pancreatic insufficiency | • Pancreatic dysfunction may become subclinical over time but those who are symptomatic may require long-term pancreatic enzyme replacement and close monitoring of stool output, nutrition, and growth |
| Cardiac | • Baseline cardiac dysfunction compounded by regimen-related toxicity | • Baseline echocardiogram and exposure-modified frequency post-HCT; referral to cardiology if abnormalities identified |
| Hepatic | • Potential for hepatic dysfunction | • Close monitoring of liver enzymes |
These recommendations have been adapted from published guidelines.1-4
SPF, sun protection factor.