Current indication for hematopoietic cell transplantation in adults

With advances in transplantation technology and supportive care practices, hematopoietic cell transplantation [HCT] has become relatively safer and the applicability of HCT continues to expand. However, appropriate selection of transplant candidates remains challenging. Identifying adult patients who may benefit from HCT involves consideration of patient and disease factors, including overall health, prior therapies, age, comorbidity, and disease/disease risk. The eligibility of transplants should be decided on a case by case basis, based upon a risk-benefit assessment. The advent of the tools for assessing patient factors such as HCT-specific comorbidity index and disease factors such as disease risk index serve as assets for the decision-making process. Besides those approaches, psychosocial assessment to know the candidates' personalities and related issues are crucial in order to maximize patients' participation in their own care and to lay the foundation for a successful return to their personal and professional life after HCT

Recommended screening and preventive practices for long-term survivors after hematopoietic cell transplantation

Advances in hematopoietic cell transplantation [HCT] technology and supportive care techniques have led to improvements in long-term survival after HCT. Emerging indications for transplantation, introduction of newer graft sources [eg, umbilical cord blood] and transplantation of older patients using less intense conditioning regimens have also contributed to an increase in the number of HCT survivors. These survivors are at risk for developing late complications secondary to pre-, peri-, and posttransplantation exposures and risk factors. Guidelines for screening and preventive practices for HCT survivors were published in 2006. An international group of transplantation experts was convened in 2011 to review contemporary literature and update the recommendations while considering the changing practice of transplantation and international applicability of these guidelines. This review provides the updated recommendations for screening and preventive practices for pediatric and adult survivors of autologous and allogeneic HCT