Case Studies Outline Strategies for Long-Term Monitoring of Adult HCT Survivors

Using 4 case studies of hematopoietic cell transplantation (HCT) recipients, the authors of this “How I treat …” series in the journal Blood illustrate the challenges involved in providing long-term care for HCT survivors, and then propose several “best practice” models for risk-based screening.

Providing complex and nuanced care for HCT recipients most often falls upon community-based, primary care physicians, who often lack the specialized knowledge to handle the unique care requirements of these patients.

The authors propose best practices including ongoing, long-term cooperation between transplant center physicians and primary care physicians.

The best models for long-term care of HCT recipients can be achieved in 3 possible options according to the authors:

  1. Specialized clinics for the long-term management of HCT survivors, with risk-based screening for early detection of late-onset complications. This service is currently being offered at several transplant programs; patients are triaged to appropriate specialists if they are identified as having a complication.
  2. Dedicated primary care physicians specialized in cancer survivorship issues take on the responsibility of managing these patients.
  3. A hybrid approach where specialized clinics at transplant centers partner with primary care physicians in the community to optimize the long-term care of transplant survivors.

The authors emphasize that to achieve the benefits of early detection and prevention of life-threatening complications, HCT survivors should undergo regular comprehensive physical examinations that include screening for functional and psychosocial consequences of treatment and receive ongoing education on monitoring their health post-transplant.

Bhatia S, et al. Blood

Related Resource