Late Effects Surveillance Recommendations among Survivors of Childhood Hematopoietic Cell Transplantation: A Children's Oncology Group Report

• Type of Material: Article
• Authors: Eric J. Chow, University of Washington; Lynnette Anderson, Medical College of Wisconsin; K. Scott Baker, University of Washington; Smita Bhatia, University of Alabama at Birmingham; Gregory M.T. Guilcher, University of Calgary; Jennifer T. Huang, Harvard University; Wendy Pelletier, University of Calgary; Joanna L. Perkins, Children’s Hospital and Clinics of Minnesota; Linda S. Rivard, Advocate Children’s Hospital; Tal Schechter, Hospital for Sick Children; Ami Jayant Shah, Stanford University; Karla Dee Wilson, City of Hope National Medical Center; Kenneth Wong, University of Southern California; Satkiran Grewal, Tufts University; Saro Armenian, City of Hope National Medical Center; Lillian Meacham, Emory University; Daniel A. Mulrooney, University of Tennessee; Sharon Castellino, Emory University
• Language: English
• Date: 2016-05-01
• Publisher: Elsevier
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2016 American Society for Blood and Marrow Transplantation.
• Final Published Version (URL): http://dx.doi.org/10.1016/j.bbmt.2016.01.023
• Title of Journal or Parent Work: Biology of Blood and Marrow Transplantation
• ISSN: 1083-8791
• Volume: 22
• Issue: 5
• Start Page: 782
• End Page: 795
• Grant/Funding Information: Supported in part by the Children’s Oncology Group National Clinical Trials Network Operations grant (U10 CA180886, PI: Adamson) from the National Cancer Institute.
• Keywords: Childhood; INTERNATIONAL CONSENSUS CONFERENCE; Late effects; Surveillance; QUALITY-OF-LIFE; CARDIOVASCULAR RISK-FACTORS; Guideline; BONE-MARROW-TRANSPLANTATION; Life Sciences & Biomedicine; Hematology; TOTAL-BODY IRRADIATION; BLOOD INSTITUTE/PEDIATRIC BLOOD; SUBSEQUENT MALIGNANT NEOPLASMS; NATIONAL-CANCER-INSTITUTE; Science & Technology; Hematopoietic cell transplantation; YOUNG-ADULT CANCERS; Immunology; TERM-FOLLOW-UP; Survivor; Transplantation
• Research Categories: Health Sciences, Oncology; Health Sciences, General; Health Sciences, Medicine and Surgery

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 specialis ts, 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.