The Long Term Follow Up (LTFU) department wants to ensure that you receive support and surveillance for any health problems that may arise following transplant. Additionally, patients may develop secondary health problems related to medications. For these reasons, we have developed specific screening guidelines to monitor for post-transplant complications so that treatment can be started before these complications become a problem.
The LTFU department and your primary transplanting physician will be involved with your referring oncologist in monitoring studies necessary to follow your original malignancy.
Post transplant re-immunizations: These include diphtheria, tetanus, pertussis, polio, pneumococcal, Haemophilus influenza type B, Hepatitis A and B, and viral influenza. Your physician will inform you when to receive these immunizations. You may also require the meningococcal or the measles, mumps and rubella vaccine (MMR) at a later time. You are not to receive live vaccines for 2 years post transplant.
Surveillance for infectious diseases: Blood cultures, urine samples, and chest x-rays may be done as surveillance procedures after transplant. Additionally, some patients undergo regular blood tests for cytomegalovirus and hepatitis. During the winter months, surveillance for respiratory viruses is done for upper respiratory complaints.
Evaluation for iron overload: Iron overload can affect vital organs such as the heart, liver, and pancreas. Routine blood work can evaluate for this problem and is done at regular intervals after transplant.
Decreased bone density or osteoporosis can occur after your transplant and needs to be evaluated with an x-ray called a DEXA scan. This is especially important for those patients on steroids. Medications can be given to prevent the development and progression of this disorder.
Graft versus Host Disease: This is a potential disorder for allogeneic patients. This disorder can affect multiple systems including the skin, mouth, eyes, gastrointestinal tract, liver, lungs, and muscles. Symptoms include the development of a rash, nausea, diarrhea and stomach cramps, muscle pain, weight loss, dry eyes, oral sensitivity, and shortness of breath. Any of these symptoms should be reported to your transplanting physician.
Endocrine disorders: Some patients may develop thyroid disorders with symptoms such as fatigue, hair thinning and loss of hair, or constipation. Thyroid function tests should be evaluated when these symptoms are present and at yearly intervals. Additionally, patients should be monitored for a reduction in male and female hormones and should discuss the risks and benefits of intervention with their transplant physician.
Depression or anxiety: These are common feelings after transplant and will be addressed regularly with the LTFU team.
Routine wellness workups (PAP smears, mammograms, colonoscopies, prostate evaluation, eye and dental exams) should be done at regular intervals, per recommendations for the general population. These studies may also be scheduled through your primary care physician. Any patient requiring dental work after transplant should inform the transplant team. Additionally, a frequent complication is the development of cataracts in those patients who have had total body irradiation or those on steroids. Symptoms include blurred vision or worsening vision at night.
In conclusion, the LTFU department is available for all post-transplant concerns, including those that occur years from your transplant date. We want to be a resource for you, your family, and your referring oncologist with our goal being to bring you back to a productive lifestyle.