Rizzo, J. D., Wingard, J. R., Tichelli, A., Lee, S. J., Van Lint, M. T., Burns, L. J., . . . Socié, G. (2006). Recommended screening and preventive practices for long-term survivors after hematopoietic cell transplantation: joint recommendations of the European Group for Blood and Marrow Transplantation, the Center for International Blood and Marrow Transplant Research, and the American Society of Blood and Marrow Transplantation. Biology of Blood and Marrow Transplantation, 12, 138–151.

To summarize recommendations for care providers regarding screening and prevention practices for adult autologous and allogeneic hematopoietic cell transplantation survivors.

This was classified as an expert opinion.

Recommended practices were developed by a consensus panel from three major blood and marrow transplantation organizations. Most recommendations were developed from studies (not cited) identifying specific complications and associated risk factors in long-term survivors.

• Patients were undergoing long-term follow-up care.
• The study has clinical applicability for late effects and survivorship. 

Guidelines for the prevention of infection for all transplantation patients include Pneumocystis carinii pneumonia prophylaxis for six months and immunization with inactivated vaccines beginning at one year posttransplantation and annually thereafter.  Other infection prevention recommendations include antibiotic prophylaxis for encapsulated microorganisms during immunosuppressive therapy for chronic graft-versus-host disease (cGVHD), possible antifungal prophylaxis for patients on chronic steroids, adhering to the American Heart Association (AHA) guidelines of antibiotic prophylaxis for oral procedures, cytomegalovirus antigen or polymerase chain reaction testing for allogeneic hematopoietic cell transplantation recipients with chronic immunosuppression or cGVHD, and possible prophylaxis for the herpes simplex virus for those on chronic immunosuppressants for cGVHD. This article also includes recommendations for many other aspects of posttransplantation care. Recommendations are summarized in two tables, one organized by body system and the other organized by time after transplantation.

The authors did not include the sources used to arrive at the consensus recommendations, with the following exceptions:

• Recommendations for prophylactic antibiotics for oral procedures follow the AHA guidelines for endocarditis prophylaxis.
• Recommendations for annual vaccinations follow either the Center for Disease Control guidelines or the European Group for Blood and Marrow Transplantation guidelines.