Official reprint from UpToDate®
www.uptodate.com ©2018 UpToDate, Inc. and/or its affiliates. All Rights Reserved.

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

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


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".)

To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information on subscription options, click below on the option that best describes you:

Subscribers log in here

Literature review current through: Dec 2017. | This topic last updated: Jan 11, 2018.
The content on the UpToDate website is not intended nor recommended as a substitute for medical advice, diagnosis, or treatment. Always seek the advice of your own physician or other qualified health care professional regarding any medical questions or conditions. The use of this website is governed by the UpToDate Terms of Use ©2018 UpToDate, Inc.
  1. Roeland E, Mitchell W, Elia G, et al. Symptom control in stem cell transplantation: a multidisciplinary palliative care team approach. Part 1: Physical symptoms. J Support Oncol 2010; 8:100.
  2. Roeland E, Mitchell W, Elia G, et al. Symptom control in stem cell transplantation: a multidisciplinary palliative care team approach. Part 2: psychosocial concerns. J Support Oncol 2010; 8:179.
  3. El-Jawahri A, LeBlanc T, VanDusen H, et al. Effect of Inpatient Palliative Care on Quality of Life 2 Weeks After Hematopoietic Stem Cell Transplantation: A Randomized Clinical Trial. JAMA 2016; 316:2094.
  4. Ho VT, Cutler C, Carter S, et al. Blood and marrow transplant clinical trials network toxicity committee consensus summary: thrombotic microangiopathy after hematopoietic stem cell transplantation. Biol Blood Marrow Transplant 2005; 11:571.
  5. Ruutu T, Barosi G, Benjamin RJ, et al. Diagnostic criteria for hematopoietic stem cell transplant-associated microangiopathy: results of a consensus process by an International Working Group. Haematologica 2007; 92:95.
  6. Kennedy GA, Bleakley S, Butler J, et al. Posttransplant thrombotic microangiopathy: sensitivity of proposed new diagnostic criteria. Transfusion 2009; 49:1884.
  7. Labrador J, López-Corral L, Vazquez L, et al. Incidence and risk factors for life-threatening bleeding after allogeneic stem cell transplant. Br J Haematol 2015; 169:719.
  8. Bernstein SH, Nademanee AP, Vose JM, et al. A multicenter study of platelet recovery and utilization in patients after myeloablative therapy and hematopoietic stem cell transplantation. Blood 1998; 91:3509.
  9. Wardley AM, Jayson GC, Swindell R, et al. Prospective evaluation of oral mucositis in patients receiving myeloablative conditioning regimens and haemopoietic progenitor rescue. Br J Haematol 2000; 110:292.
  10. Robien K, Schubert MM, Bruemmer B, et al. Predictors of oral mucositis in patients receiving hematopoietic cell transplants for chronic myelogenous leukemia. J Clin Oncol 2004; 22:1268.
  11. Fanning SR, Rybicki L, Kalaycio M, et al. Severe mucositis is associated with reduced survival after autologous stem cell transplantation for lymphoid malignancies. Br J Haematol 2006; 135:374.
  12. Blijlevens N, Schwenkglenks M, Bacon P, et al. Prospective oral mucositis audit: oral mucositis in patients receiving high-dose melphalan or BEAM conditioning chemotherapy--European Blood and Marrow Transplantation Mucositis Advisory Group. J Clin Oncol 2008; 26:1519.
  13. Lalla RV, Bowen J, Barasch A, et al. MASCC/ISOO clinical practice guidelines for the management of mucositis secondary to cancer therapy. Cancer 2014; 120:1453.
  14. Scolapio JS, Tarrosa VB, Stoner GL, et al. Audit of nutrition support for hematopoietic stem cell transplantation at a single institution. Mayo Clin Proc 2002; 77:654.
  15. Weisdorf SA, Lysne J, Wind D, et al. Positive effect of prophylactic total parenteral nutrition on long-term outcome of bone marrow transplantation. Transplantation 1987; 43:833.
  16. Charuhas PM, Fosberg KL, Bruemmer B, et al. A double-blind randomized trial comparing outpatient parenteral nutrition with intravenous hydration: effect on resumption of oral intake after marrow transplantation. JPEN J Parenter Enteral Nutr 1997; 21:157.
  17. Jones JA, Qazilbash MH, Shih YC, et al. In-hospital complications of autologous hematopoietic stem cell transplantation for lymphoid malignancies: clinical and economic outcomes from the Nationwide Inpatient Sample. Cancer 2008; 112:1096.
  18. Playford RJ, Marchbank T, Mandir N, et al. Effects of keratinocyte growth factor (KGF) on gut growth and repair. J Pathol 1998; 184:316.
  19. Farrell CL, Bready JV, Rex KL, et al. Keratinocyte growth factor protects mice from chemotherapy and radiation-induced gastrointestinal injury and mortality. Cancer Res 1998; 58:933.
  20. Spielberger R, Stiff P, Bensinger W, et al. Palifermin for oral mucositis after intensive therapy for hematologic cancers. N Engl J Med 2004; 351:2590.
  21. Tsirigotis P, Triantafyllou K, Girkas K, et al. Keratinocyte growth factor is effective in the prevention of intestinal mucositis in patients with hematological malignancies treated with high-dose chemotherapy and autologous hematopoietic SCT: a video-capsule endoscopy study. Bone Marrow Transplant 2008; 42:337.
  22. Kobbe G, Bruns I, Schroeder T, et al. A 3-day short course of palifermin before HDT reduces toxicity and need for supportive care after autologous blood stem-cell transplantation in patients with multiple myeloma. Ann Oncol 2010; 21:1898.
  23. Hensley ML, Hagerty KL, Kewalramani T, et al. American Society of Clinical Oncology 2008 clinical practice guideline update: use of chemotherapy and radiation therapy protectants. J Clin Oncol 2009; 27:127.
  24. Jagasia MH, Abonour R, Long GD, et al. Palifermin for the reduction of acute GVHD: a randomized, double-blind, placebo-controlled trial. Bone Marrow Transplant 2012; 47:1350.
  25. Blazar BR, Weisdorf DJ, Defor T, et al. Phase 1/2 randomized, placebo-control trial of palifermin to prevent graft-versus-host disease (GVHD) after allogeneic hematopoietic stem cell transplantation (HSCT). Blood 2006; 108:3216.
  26. Langner S, Staber P, Schub N, et al. Palifermin reduces incidence and severity of oral mucositis in allogeneic stem-cell transplant recipients. Bone Marrow Transplant 2008; 42:275.
  27. Krijanovski OI, Hill GR, Cooke KR, et al. Keratinocyte growth factor separates graft-versus-leukemia effects from graft-versus-host disease. Blood 1999; 94:825.
  28. Du X, Williams DA. Interleukin-11: review of molecular, cell biology, and clinical use. Blood 1997; 89:3897.
  29. Opal SM, Jhung JW, Keith JC Jr, et al. Additive effects of human recombinant interleukin-11 and granulocyte colony-stimulating factor in experimental gram-negative sepsis. Blood 1999; 93:3467.
  30. Opal SM, Keith JC Jr, Jhung J, et al. Orally administered recombinant human interleukin-11 is protective in experimental neutropenic sepsis. J Infect Dis 2003; 187:70.
  31. Ellis M, Zwaan F, Hedström U, et al. Recombinant human interleukin 11 and bacterial infection in patients with [correction of] haematological malignant disease undergoing chemotherapy: a double-blind placebo-controlled randomised trial. Lancet 2003; 361:275.
  32. Capelli D, Santini G, De Souza C, et al. Amifostine can reduce mucosal damage after high-dose melphalan conditioning for peripheral blood progenitor cellautotransplant: a retrospective study. Br J Haematol 2000; 110:300.
  33. van Kraaij MG, Dekker AW, Verdonck LF, et al. Infectious gastro-enteritis: an uncommon cause of diarrhoea in adult allogeneic and autologous stem cell transplant recipients. Bone Marrow Transplant 2000; 26:299.
  34. Bow EJ, Loewen R, Cheang MS, et al. Cytotoxic therapy-induced D-xylose malabsorption and invasive infection during remission-induction therapy for acute myeloid leukemia in adults. J Clin Oncol 1997; 15:2254.
  35. Davila ML. Neutropenic enterocolitis. Curr Opin Gastroenterol 2006; 22:44.
  36. Deeg HJ, Socie G. Malignancies after hematopoietic stem cell transplantation: many questions, some answers. Blood 1998; 91:1833.
  37. Herrera AF, Soriano G, Bellizzi AM, et al. Cord colitis syndrome in cord-blood stem-cell transplantation. N Engl J Med 2011; 365:815.
  38. Bhatt AS, Freeman SS, Herrera AF, et al. Sequence-based discovery of Bradyrhizobium enterica in cord colitis syndrome. N Engl J Med 2013; 369:517.
  39. McDonald GB, Schoch HG, Gooley TA. Liver dysfunction and mortality after allogeneic marrow transplantation: Analysis of 1419 consecutive patients (abstract). Hepatology 1999; 30:162A.
  40. Hogan WJ, Maris M, Storer B, et al. Hepatic injury after nonmyeloablative conditioning followed by allogeneic hematopoietic cell transplantation: a study of 193 patients. Blood 2004; 103:78.
  41. Arai S, Lee LA, Vogelsang GB. A systematic approach to hepatic complications in hematopoietic stem cell transplantation. J Hematother Stem Cell Res 2002; 11:215.
  42. Gooley TA, Rajvanshi P, Schoch HG, McDonald GB. Serum bilirubin levels and mortality after myeloablative allogeneic hematopoietic cell transplantation. Hepatology 2005; 41:345.
  43. Ruutu T, Eriksson B, Remes K, et al. Ursodeoxycholic acid for the prevention of hepatic complications in allogeneic stem cell transplantation. Blood 2002; 100:1977.
  44. van der Meer JW, Guiot HF, van den Broek PJ, van Furth R. Infections in bone marrow transplant recipients. Semin Hematol 1984; 21:123.
  45. Peggs KS, Mackinnon S. Immune reconstitution following haematopoietic stem cell transplantation. Br J Haematol 2004; 124:407.
  46. Infectious Diseases Society of America. http://www.idsociety.org/Content.aspx?id=9088 (Accessed on February 26, 2008).
  47. Prieto JM, Blanch J, Atala J, et al. Stem cell transplantation: risk factors for psychiatric morbidity. Eur J Cancer 2006; 42:514.
  48. Sun CL, Francisco L, Baker KS, et al. Adverse psychological outcomes in long-term survivors of hematopoietic cell transplantation: a report from the Bone Marrow Transplant Survivor Study (BMTSS). Blood 2011; 118:4723.
  49. El-Jawahri AR, Traeger LN, Kuzmuk K, et al. Quality of life and mood of patients and family caregivers during hospitalization for hematopoietic stem cell transplantation. Cancer 2015; 121:951.
  50. Fann JR, Roth-Roemer S, Burington BE, et al. Delirium in patients undergoing hematopoietic stem cell transplantation. Cancer 2002; 95:1971.
  51. Fann JR, Alfano CM, Roth-Roemer S, et al. Impact of delirium on cognition, distress, and health-related quality of life after hematopoietic stem-cell transplantation. J Clin Oncol 2007; 25:1223.
  52. Fann JR, Hubbard RA, Alfano CM, et al. Pre- and post-transplantation risk factors for delirium onset and severity in patients undergoing hematopoietic stem-cell transplantation. J Clin Oncol 2011; 29:895.
  53. Higman MA, Port JD, Beauchamp NJ Jr, Chen AR. Reversible leukoencephalopathy associated with re-infusion of DMSO preserved stem cells. Bone Marrow Transplant 2000; 26:797.
  54. Bauwens D, Hantson P, Laterre PF, et al. Recurrent seizure and sustained encephalopathy associated with dimethylsulfoxide-preserved stem cell infusion. Leuk Lymphoma 2005; 46:1671.
  55. Chen-Plotkin AS, Vossel KA, Samuels MA, Chen MH. Encephalopathy, stroke, and myocardial infarction with DMSO use in stem cell transplantation. Neurology 2007; 68:859.
  56. Siegel SD. Psychosocial considerations in hematopoietic stem cell transplantation: implications for patient quality of life and post- transplant survival. J Psychosoc Oncol 2008; 5:407.
  57. Foster LW, McLellan LJ, Rybicki LA, et al. Survival of patients who have undergone allogeneic bone marrow transplantation: The relative importance of in-hospital lay care-partner support. J Psychosoc Oncol 2004; 22:1.
  58. Frick E, Motzke C, Fischer N, et al. Is perceived social support a predictor of survival for patients undergoing autologous peripheral blood stem cell transplantation? Psychooncology 2005; 14:759.
  59. DuHamel KN, Mosher CE, Winkel G, et al. Randomized clinical trial of telephone-administered cognitive-behavioral therapy to reduce post-traumatic stress disorder and distress symptoms after hematopoietic stem-cell transplantation. J Clin Oncol 2010; 28:3754.
  60. Lee SJ, Fairclough D, Parsons SK, et al. Recovery after stem-cell transplantation for hematologic diseases. J Clin Oncol 2001; 19:242.
  61. van Haren IE, Timmerman H, Potting CM, et al. Physical exercise for patients undergoing hematopoietic stem cell transplantation: systematic review and meta-analyses of randomized controlled trials. Phys Ther 2013; 93:514.
  62. https://web.emmes.com/study/bmt2/protocol/0902_protocol/0902%20Exercise%20Stress%20Protocol%20v2.pdf (Accessed on July 16, 2013).
  63. Lee SJ, Fairclough D, Antin JH, Weeks JC. Discrepancies between patient and physician estimates for the success of stem cell transplantation. JAMA 2001; 285:1034.
  64. Ganti AK, Lee SJ, Vose JM, et al. Outcomes after hematopoietic stem-cell transplantation for hematologic malignancies in patients with or without advance care planning. J Clin Oncol 2007; 25:5643.
  65. Gratwohl A, Hermans J, Goldman JM, et al. Risk assessment for patients with chronic myeloid leukaemia before allogeneic blood or marrow transplantation. Chronic Leukemia Working Party of the European Group for Blood and Marrow Transplantation. Lancet 1998; 352:1087.
  66. Parimon T, Au DH, Martin PJ, Chien JW. A risk score for mortality after allogeneic hematopoietic cell transplantation. Ann Intern Med 2006; 144:407.
  67. Sorror ML, Maris MB, Storb R, et al. Hematopoietic cell transplantation (HCT)-specific comorbidity index: a new tool for risk assessment before allogeneic HCT. Blood 2005; 106:2912.
  68. Kataoka K, Nannya Y, Ueda K, et al. Differential prognostic impact of pretransplant comorbidity on transplant outcomes by disease status and time from transplant: a single Japanese transplant centre study. Bone Marrow Transplant 2010; 45:513.
  69. Gooley TA, Chien JW, Pergam SA, et al. Reduced mortality after allogeneic hematopoietic-cell transplantation. N Engl J Med 2010; 363:2091.
  70. Horan JT, Logan BR, Agovi-Johnson MA, et al. Reducing the risk for transplantation-related mortality after allogeneic hematopoietic cell transplantation: how much progress has been made? J Clin Oncol 2011; 29:805.
  71. Hahn T, McCarthy PL Jr, Hassebroek A, et al. Significant improvement in survival after allogeneic hematopoietic cell transplantation during a period of significantly increased use, older recipient age, and use of unrelated donors. J Clin Oncol 2013; 31:2437.
  72. Passweg JR, Walker I, Sobocinski KA, et al. Validation and extension of the EBMT Risk Score for patients with chronic myeloid leukaemia (CML) receiving allogeneic haematopoietic stem cell transplants. Br J Haematol 2004; 125:613.
  73. Gratwohl A, Stern M, Brand R, et al. Risk score for outcome after allogeneic hematopoietic stem cell transplantation: a retrospective analysis. Cancer 2009; 115:4715.
  74. Charlson M, Szatrowski TP, Peterson J, Gold J. Validation of a combined comorbidity index. J Clin Epidemiol 1994; 47:1245.
  75. Smith AR, Majhail NS, MacMillan ML, et al. Hematopoietic cell transplantation comorbidity index predicts transplantation outcomes in pediatric patients. Blood 2011; 117:2728.
  76. Sorror M, Storer B, Sandmaier BM, et al. Hematopoietic cell transplantation-comorbidity index and Karnofsky performance status are independent predictors of morbidity and mortality after allogeneic nonmyeloablative hematopoietic cell transplantation. Cancer 2008; 112:1992.
  77. Lim Z, Pagliuca A, Simpson S, et al. Outcomes of patients with haematological malignancies admitted to intensive care unit. A comparative review of allogeneic haematopoietic stem cell transplantation data. Br J Haematol 2007; 136:448.
  78. Price KJ, Thall PF, Kish SK, et al. Prognostic indicators for blood and marrow transplant patients admitted to an intensive care unit. Am J Respir Crit Care Med 1998; 158:876.
  79. Soubani AO, Kseibi E, Bander JJ, et al. Outcome and prognostic factors of hematopoietic stem cell transplantation recipients admitted to a medical ICU. Chest 2004; 126:1604.
  80. Pène F, Aubron C, Azoulay E, et al. Outcome of critically ill allogeneic hematopoietic stem-cell transplantation recipients: a reappraisal of indications for organ failure supports. J Clin Oncol 2006; 24:643.
  81. Kew AK, Couban S, Patrick W, et al. Outcome of hematopoietic stem cell transplant recipients admitted to the intensive care unit. Biol Blood Marrow Transplant 2006; 12:301.
  82. Benz R, Schanz U, Maggiorini M, et al. Risk factors for ICU admission and ICU survival after allogeneic hematopoietic SCT. Bone Marrow Transplant 2014; 49:62.
  83. Rubenfeld GD, Crawford SW. Withdrawing life support from mechanically ventilated recipients of bone marrow transplants: a case for evidence-based guidelines. Ann Intern Med 1996; 125:625.
  84. Jenkins P, Johnston LJ, Pickham D, et al. Intensive Care Utilization for Hematopoietic Cell Transplant Recipients. Biol Blood Marrow Transplant 2015; 21:2023.
  85. Socié G, Salooja N, Cohen A, et al. Nonmalignant late effects after allogeneic stem cell transplantation. Blood 2003; 101:3373.
  86. Lee SJ, Loberiza FR, Antin JH, et al. Routine screening for psychosocial distress following hematopoietic stem cell transplantation. Bone Marrow Transplant 2005; 35:77.
  87. Bhatia S, Robison LL, Francisco L, et al. Late mortality in survivors of autologous hematopoietic-cell transplantation: report from the Bone Marrow Transplant Survivor Study. Blood 2005; 105:4215.
  88. Faraci M, Barra S, Cohen A, et al. Very late nonfatal consequences of fractionated TBI in children undergoing bone marrow transplant. Int J Radiat Oncol Biol Phys 2005; 63:1568.
  89. Bhatia S, Francisco L, Carter A, et al. Late mortality after allogeneic hematopoietic cell transplantation and functional status of long-term survivors: report from the Bone Marrow Transplant Survivor Study. Blood 2007; 110:3784.
  90. Abou-Mourad YR, Lau BC, Barnett MJ, et al. Long-term outcome after allo-SCT: close follow-up on a large cohort treated with myeloablative regimens. Bone Marrow Transplant 2010; 45:295.
  91. Norlin AC, Sairafi D, Mattsson J, et al. Allogeneic stem cell transplantation: low immunoglobulin levels associated with decreased survival. Bone Marrow Transplant 2008; 41:267.
  92. Ramaprasad C, Pouch S, Pitrak DL. Neutrophil function after bone marrow and hematopoietic stem cell transplant. Leuk Lymphoma 2010; 51:756.
  93. Boer CC, Correa ME, Miranda EC, de Souza CA. Taste disorders and oral evaluation in patients undergoing allogeneic hematopoietic SCT. Bone Marrow Transplant 2010; 45:705.
  94. Armenian SH, Sun CL, Francisco L, et al. Late congestive heart failure after hematopoietic cell transplantation. J Clin Oncol 2008; 26:5537.
  95. Majhail NS, Flowers ME, Ness KK, et al. High prevalence of metabolic syndrome after allogeneic hematopoietic cell transplantation. Bone Marrow Transplant 2009; 43:49.
  96. Hingorani S, Guthrie KA, Schoch G, et al. Chronic kidney disease in long-term survivors of hematopoietic cell transplant. Bone Marrow Transplant 2007; 39:223.
  97. Grönroos MH, Bolme P, Winiarski J, Berg UB. Long-term renal function following bone marrow transplantation. Bone Marrow Transplant 2007; 39:717.
  98. Inaba H, Yang J, Pan J, et al. Pulmonary dysfunction in survivors of childhood hematologic malignancies after allogeneic hematopoietic stem cell transplantation. Cancer 2010; 116:2020.
  99. Majhail NS, Lazarus HM, Burns LJ. Iron overload in hematopoietic cell transplantation. Bone Marrow Transplant 2008; 41:997.
  100. Baker KS, Ness KK, Steinberger J, et al. Diabetes, hypertension, and cardiovascular events in survivors of hematopoietic cell transplantation: a report from the bone marrow transplantation survivor study. Blood 2007; 109:1765.
  101. Tichelli A, Bucher C, Rovó A, et al. Premature cardiovascular disease after allogeneic hematopoietic stem-cell transplantation. Blood 2007; 110:3463.
  102. Tichelli A, Bhatia S, Socié G. Cardiac and cardiovascular consequences after haematopoietic stem cell transplantation. Br J Haematol 2008; 142:11.
  103. Griffith ML, Savani BN, Boord JB. Dyslipidemia after allogeneic hematopoietic stem cell transplantation: evaluation and management. Blood 2010; 116:1197.
  104. Taskinen M, Saarinen-Pihkala UM, Hovi L, et al. Bone health in children and adolescents after allogeneic stem cell transplantation: high prevalence of vertebral compression fractures. Cancer 2007; 110:442.
  105. Rovó A, Tichelli A, Passweg JR, et al. Spermatogenesis in long-term survivors after allogeneic hematopoietic stem cell transplantation is associated with age, time interval since transplantation, and apparently absence of chronic GvHD. Blood 2006; 108:1100.
  106. Humphreys CT, Tallman B, Altmaier EM, Barnette V. Sexual functioning in patients undergoing bone marrow transplantation: a longitudinal study. Bone Marrow Transplant 2007; 39:491.
  107. Hammond C, Abrams JR, Syrjala KL. Fertility and risk factors for elevated infertility concern in 10-year hematopoietic cell transplant survivors and case-matched controls. J Clin Oncol 2007; 25:3511.
  108. Syrjala KL, Kurland BF, Abrams JR, et al. Sexual function changes during the 5 years after high-dose treatment and hematopoietic cell transplantation for malignancy, with case-matched controls at 5 years. Blood 2008; 111:989.
  109. Poppelreuter M, Weis J, Mumm A, et al. Rehabilitation of therapy-related cognitive deficits in patients after hematopoietic stem cell transplantation. Bone Marrow Transplant 2008; 41:79.
  110. Chang G, Meadows ME, Orav EJ, Antin JH. Mental status changes after hematopoietic stem cell transplantation. Cancer 2009; 115:4625.
  111. Wingard JR, Majhail NS, Brazauskas R, et al. Long-term survival and late deaths after allogeneic hematopoietic cell transplantation. J Clin Oncol 2011; 29:2230.
  112. Martin PJ, Counts GW Jr, Appelbaum FR, et al. Life expectancy in patients surviving more than 5 years after hematopoietic cell transplantation. J Clin Oncol 2010; 28:1011.