Long Term Follow up Phase
Patient is discharged from hospital and followed closely in outpatient clinic (at first 2 to 3 times per week).
This period lasts for months to years. During this time the patient's immune system and bone marrow recovers. Ongoing management consists of:
- Gradually weaning off of immunosuppression
- Management of Chronic GVHD
Transplants using T-cell depletion or from mismatched or haplotypic sources often have delayed or incomplete immune reconstitution.
Close monitoring of blood counts, signs and symptoms of infection or graft-versus-host disease, and adjusting of immune suppression.
Over months to years following HSCT both subspecialist HSCT physician and patient’s family doctor / pediatrician monitor patient for long-term complications of transplant.
Full immune reconstitution with the development of a proper adaptive immunity response takes 12-24 months following HSCT. Therefore patients remain at risk for opportunistic infections during this time. Development of cGVHD prolongs the process of immune reconstitution.
