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Adherence to long-term follow-up preventive practices in allogeneic hematopoietic cell transplantation survivors from North India
Niranjan S. Khaire1, Prashant Chhabra1, Dikshat G. Gupta1, Aditya Jandial1, Alka Khadwal1, Kripa Shanker Kasudhan1, Shaweta Kaundal1, Madhu Chopra1, Arihant Jain1, Gaurav Prakash1, Navneet S. Majhail2, Pankaj Malhotra1, Deepesh P. Lad1

1Department of Clinical Hematology and Medical Oncology, Postgraduate Institute of Medical Education and Research, Chandigarh, India

2Sarah Cannon Transplant and Cellular Therapy Program at TriStar Centennial, Nashville, USA

Keywords
LTFU care, allo-HCT, adherence, cardio-metabolic
Submitted:December 31, 2021
Accepted:February 28, 2022
Published online:June 10, 2022
DOI:

Abstract

Introduction: There are existing international guidelines for long-term follow-up (LTFU) care of allogeneic hematopoietic cell transplantation (allo-HCT) survivors. However, implementing these guidelines represents a unique challenge in resource-challenged settings.

Methods: This study aimed to evaluate adherence to recommended surveillance in allo-HCT survivors at an academic center in North India and study the incidence of late effects. This single-center, retrospective study analyzed records of allo-HCT recipients from 2016 to 2020. Survivors were screened in our LTFU clinic at day +100 and +365 using cardiometabolic parameters (screening for hypertension, dyslipidemia, hyperglycemia, 24-hour urine protein, thyroid function), pulmonary function test (PFT), bone mineral density (BMD), and initiation of revaccination.

Results: A total of 40/80 (50%) allo-HCT survivors were alive at a median of 888 days (IQR 515-1,306). The adherence to home-based screening parameters such as blood pressure and blood glucose was highest (>75%), followed by lab-based parameters (45-70%), and lowest for specialized tests such as PFT (<50%) at both day +100 and +365 time points. Adherence to the initiation of revaccination was only 67%. At least one cardiometabolic parameter was out of range in 55% and 63% of survivors at day +100 and +365, respectively.

Conclusion: The adherence to recommended surveillance measures for allo-HCT survivors in an academic LTFU clinic at one year was only 75% overall. Cardiometabolic abnormalities were noted in more than half of the survivors. This study emphasizes the need for a structured LTFU clinic in all centers performing HCT.

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Online ISSN:2432-7026