Late Effects after Stem Cell Transplant

Patients who receive allogeneic or autologous stem cell transplants are usually observed for a long time after transplantation to determine whether side effects are present. Recipients of conditioning regimens in which total body irradiation was used are at risk of endocrine (gland) problems that include hypothyroidism, adrenal insufficiency or growth hormone insufficiency. Therefore, it is important that the patient’s height and weight be serially evaluated, when necessary, monitored by an endocrinologist.
Survivors of stem cell transplantation are at increased risk of osteoporosis or weakening of the bones. This complication is largely due to the treatment required during the transplant process, and the use of corticosteroids, which are used to treat graft-vs-host disease (GvHD). Pulmonary and cardiac abnormalities should be followed by routine screening examinations. In addition, survivors of transplantation have been shown to be at high risk of second malignancies, which include leukemia, brain tumors and skin cancers. The type of late effects for which a patient is at risk vary according to the type of conditioning regimen administered.