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11 - Transplant-related complications

Published online by Cambridge University Press:  05 November 2013

Joseph H. Antin
Affiliation:
Dana-Farber Cancer Institute, Boston
Deborah Yolin Raley
Affiliation:
Dana-Farber Cancer Institute, Boston
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Summary

When making a differentialdiagnosis in a patient who has undergone hematopoietic stem celltransplantation (HSCT), it is critical to have a solid understanding of theentire course of treatment. This includes transplant type (autologous orallogeneic) including intensity of chemotherapy, stem cell source (marrow,peripheral blood [PB], or cord blood), donor match (related or unrelated,matched or mismatched), interval post-HSCT (early or late),graft-versus-host disease (GVHD) prophylaxis, infectious prophylaxis,current immune suppressive medications, and length of granulocytopenia.Transplant-related toxicities can include treatment-related organ damage,infection, GVHD, or any other combination. Time course is generallyconsidered as follows: early – first 30 days when pancytopenia and thedirect effect of chemotherapy is greatest; mild – day 15 to roughly day 100;and late – after day 100. There is often an overlap in timing ofcomplications.

In the remainder of the bookyou will find information on the following transplant-relatedcomplications:

  • GVHD – prevention, acute and chronic;

  • engraftment syndrome;

  • infectious disease;

  • graft rejection and failure;

  • gastrointestinal complications;

  • oral care and complications;

  • pulmonary complications;

  • veno-occlusive disease;

  • special transfusion-related situations;

  • cardiovascular complications;

  • neurological complications;

  • cystitis;

  • donor lymphocyte infusion.

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    Publisher: Cambridge University Press
    Print publication year: 2013

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