Summary: Late effects after an allogeneic transplant (a transplant using donor cells) can affect the physical, psychological, and social well-being of survivors. Dr. Hamilton sheds light on the most common long-term effects and how they can best be managed to minimize complications. She also stresses the importance of ongoing survivorship care to ensure that survivors can live life to the fullest.
Presenter: Betty Hamilton MD, Cleveland Clinic
Many thanks to Sanofi whose support helped make this Survivorship Symposium possible
To read this transcript, go to: bmtinfonet.org/video/survivin...
Highlights:
(02:35): There are currently 200,000 transplant survivors in the United States. This number is expected to grow to over half a million by 2030. In a large BMT survivor study, 66% of patients reported at least one chronic health condition. 18% reported severe conditions.
(08:58): Physical symptoms, psychological well-being, social functioning, and environmental factors are all factors that can affect the quality of life in transplant survivors.
(13:54): Previous chemotherapy and radiation, GVHD, medications, hormone changes, and chronic inflammation all contribute to late effects after transplant.
(16:47): A multidisciplinary team of specialists is required to best care for transplant survivors with late effects of therapy.
(18:08): Cardiovascular disease and metabolic syndrome are common late effects of therapy. Metabolic syndrome can affect up to 50% of post-transplant patients, and those with metabolic disease are 2-3 times more likely to develop cardiovascular disease.
(21:39): Maintaining a healthy lifestyle, including proper diet and regular exercise, can help prevent the development of accelerated cardiovascular disease.
(23:40): Secondary cancers are a potential long-term effect seen in transplant survivors. There is a 22% increased risk of a second cancer 30 years post-transplant. GVHD is a common risk factor for the development of secondary cancers.
(26:31): An increased risk of infections is observed in transplant recipients. Older age, chronic GVHD, and unrelated donors are all risk factors. Infections can contribute to death late after transplant.
(27:56): Bone mineral density loss is observed in 50-75% of transplant survivors. Risk factors include older age, being female, low body weight, poor nutrition, and chronic kidney and liver disease. Low bone mineral density is linked to a higher risk of fractures.
(31:54): It is crucial to establish a survivorship care plan. Patients with low income, lack of insurance, and from racial minorities are at an increased risk of not receiving survivorship care.
(35:39): Multidisciplinary, formal survivorship visits at days 100 and one year can be helpful to screen and treat long-term effects.
April 2024, Part of the Virtual Celebrating a Second Chance at life Survivorship Symposium 2024
This presentation lasts 38 minutes, followed by 19 minutes of Q&A.
Key Points:
There is a significant burden of late and long-term effects of therapy after an allogeneic transplant, including chronic graft-versus-host disease (GVHD), cardiovascular complications and an increased risk for secondary cancers.
Improved screening, risk identification, and early treatment can help minimize long-term complications and side effects.
Maintaining a healthy lifestyle, including regular exercise, a well-rounded diet, and ongoing survivorship medical care can improve outcomes in patients who have had an allogeneic transplant.
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