Stem cell transplant complications

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Background

  • Autologous or allogenic
  • Cells harvested from bone marrow or peripherally
  • Treats various malignant and benign heme/onc diseases
  • Phases of recipient transplant process
    • Conditioning with radiation (usually total body) and/or chemotherapy
      • Goals: eliminate underlying malignancy, prevent rejection
    • Infusion
    • Neutropenic phase (weeks 2-4): no functioning immune system
    • Engraftment phase: highest risk of acute GVHD, lasts several weeks
    • Post-engraftment phase

Clinical Features/Differential

Neurologic complications

Higher risk with allogenic transplant

Cardiac complications

Pulmonary complications

GI complications

Renal complications

Graft-vs-host disease

Infection

See also neutropenic fever and Immunocompromised antibiotics

Treatment adverse effects

Evaluation

  • CBC, BMP, Mg/Phos
  • Low threshold for infectious workup
  • Additional evaluation dependent on presentation

Management

Disposition

  • Most complications will require admission

See Also

External Links

References