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Author Notes:

Corresponding author: Eric J. Chow, Fred Hutchinson Cancer Research Center, PO Box 19024, Seattle WA 98109.

The authors thank Lise Yasui, Melissa Hudson, Wendy Landier, and Louis Constine for their critical review of this work, and for their dedication to the maintenance of the COG Long-Term Follow-Up Guidelines.

The authors declare no conflicts of interests, including no competing financial interests

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Research Funding:

Supported in part by the Children’s Oncology Group National Clinical Trials Network Operations grant (U10 CA180886, PI: Adamson) from the National Cancer Institute.


  • Science & Technology
  • Life Sciences & Biomedicine
  • Hematology
  • Immunology
  • Transplantation
  • Childhood
  • Guideline
  • Hematopoietic cell transplantation
  • Late effects
  • Surveillance
  • Survivor

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

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Journal Title:

Biology of Blood and Marrow Transplantation


Volume 22, Number 5


, Pages 782-795

Type of Work:

Article | Post-print: After Peer Review


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.

Copyright information:

© 2016 American Society for Blood and Marrow Transplantation.

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