Table 7.

Long-term management considerations after allogeneic HCT and GT

Management areaSpecific needs
Transplant related Regular follow-ups for GVHD and infection screening 
Engraftment and chimerism monitoring 
SCD Annual eye assessments for retinopathy screening 
Ongoing assessment of organ function especially in areas of previous damage (kidney, lung, etc) 
Chronic pain management Assessment for any evidence of ongoing pain due to previous bone/muscular damage or caused by opioid-induced hyperalgesia 
Long-term pain plan discussion including goals of weaning off opioids or switching to buprenorphine-based pain management 
Psychosocial monitoring Evaluation for depression, anxiety, and posttraumatic stress disorder 
Counseling for emotional and psychological adjustment 
Social determinants of health assessment 
Neurocognitive monitoring Neurocognitive testing to assist people with entering school or workforce 
Referral for neurocognitive rehabilitation of needed 
Evaluation for any progression of previous infarcts or CNS-vascular damage 
Lifestyle adjustment Ensure individual understands the needing for continuous health care coverage 
Guidance on healthy diet and physical activity 
Education on navigating and understanding the adult health care systems 
Identification of other health providers (PCP and GYN) needed for the adult 
Management areaSpecific needs
Transplant related Regular follow-ups for GVHD and infection screening 
Engraftment and chimerism monitoring 
SCD Annual eye assessments for retinopathy screening 
Ongoing assessment of organ function especially in areas of previous damage (kidney, lung, etc) 
Chronic pain management Assessment for any evidence of ongoing pain due to previous bone/muscular damage or caused by opioid-induced hyperalgesia 
Long-term pain plan discussion including goals of weaning off opioids or switching to buprenorphine-based pain management 
Psychosocial monitoring Evaluation for depression, anxiety, and posttraumatic stress disorder 
Counseling for emotional and psychological adjustment 
Social determinants of health assessment 
Neurocognitive monitoring Neurocognitive testing to assist people with entering school or workforce 
Referral for neurocognitive rehabilitation of needed 
Evaluation for any progression of previous infarcts or CNS-vascular damage 
Lifestyle adjustment Ensure individual understands the needing for continuous health care coverage 
Guidance on healthy diet and physical activity 
Education on navigating and understanding the adult health care systems 
Identification of other health providers (PCP and GYN) needed for the adult 

CNS, central nervous system; GYN, Gynaecologist; PCP, Primary Care Physician.

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