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Management of the hematopoietic cell transplant recipient in the immediate post-transplant period

Author
Robert S Negrin, MD
Section Editor
Nelson J Chao, MD
Deputy Editor
Alan G Rosmarin, MD

INTRODUCTION

Among patients undergoing hematopoietic cell transplantation (HCT), advances in hematopoietic support; improvements in antibiotics, antifungal agents, and antiviral drugs; and better medications to control side effects of treatment such as nausea, vomiting, diarrhea and pain have all had a major impact on the clinical course.

In terms of decreased morbidity and mortality after autologous transplantation, probably the single most important advance has been the introduction of mobilized peripheral blood progenitor cells (PBPCs) as the source of hematopoietic stem cells. This approach results in more rapid recovery, which has significantly reduced the duration of antibiotic therapy, the degree of mucositis, the length of hospitalization, and the risk of the transplant procedure itself. These positive developments have resulted in a marked decline in the discomfort that patients experience in the transplant setting. (See "Sources of hematopoietic stem cells".)

The term "hematopoietic cell transplantation" (HCT) will be used throughout this review as a general term to cover transplantation of stem and progenitor cells from any source (eg, bone marrow, peripheral blood, umbilical cord blood). Otherwise, the source of such cells will be specified (eg, autologous PBPC transplantation).

General supportive care measures for patients following HCT and long term complications of HCT will be reviewed here [1,2]. Hematopoietic support after HCT and the prevention and treatment of acute and chronic graft versus host disease are discussed separately. (See "Hematopoietic support after hematopoietic cell transplantation" and "Prevention of acute graft-versus-host disease" and "Treatment of chronic graft-versus-host disease".)

The diagnosis and treatment of pulmonary, renal, and infectious complications following HCT are also presented separately. (See "Pulmonary complications after allogeneic hematopoietic cell transplantation" and "Pulmonary complications after autologous hematopoietic cell transplantation" and "Kidney disease following hematopoietic cell transplantation" and "Overview of infections following hematopoietic cell transplantation".)

                                  

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Literature review current through: Nov 2016. | This topic last updated: Tue Apr 26 00:00:00 GMT 2016.
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