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Meet the Professor Scott Baker Shahrukh Hashmi. Need for survivorship Clinics. Majority of the hematopoietic cell transplant recipients are surviving beyond 2 year mark There risk of acquiring late effects is more than general population
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Need for survivorship Clinics • Majority of the hematopoietic cell transplant recipients are surviving beyond 2 year mark • There risk of acquiring late effects is more than general population • Late effects occur across all domains of healthcare (physical, social and psychologic) • New malignancies and cardiovascular causes are responsible for late mortality in majority of the patients • NIH Late effects panel and ASBMT have emphasized the need for long term follow up (LTFU) or survivorship clinics • FACT and JACIE now has language regarding long term follow up of HCT survivors
Obstacles in establishing a survivorship program • Leadership motivation • Financial resources • Human resources • Limitation of expertise • Lack of sub-specialists • Lack of evidence based guidelines • Logistics (follow-up issues and absence of telemedicine) • Many others
Discussion • How should the LTFU clinic run? Logistics, database, staffing? • Who should be running the LTFU clinic? • Should GVHD and LTFU clinics be separate or combined? • Should pediatric and adult survivors have a combined clinic? • Should QoLoutcomes be assessed in LTFU clinics? • What guidelines should be followed for surveillance and preventative services? • Are all preventative services and visits covered by CMS and by private insurers? • Others