Canterbury DHB

Context

Cancer Screening in HCT Survivors

Summary of recommendations for cancer screening in HCT survivors

 

Risk factors

Recommendations

Skin cancer

TBI

GVHD

Young age

Annual follow-up to stress skin cancer awareness

Encourage photoprotection

Physical examination for skin cancer screening

Thyroid cancer

≤ 20 years at HCT

Female

Chronic GVHD

Irradiation

Neck palpation yearly

Oropharyngeal cancer

Chronic GVHD on IST for >24 months

Male

Annual dental review

Smoking cessation

Oesophageal cancer

Chronic GHVD, particularly extensive type

>24 months on IST

Educate on risk factors (tobacco, alcohol, GORD) and symptoms

OGD for GORD or dysphagia

Hepatocellular carcinoma

Age <34 at HCT (SIR 200)

TBI

HCV

6-monthly USS in patients at high risk is recommended by AASLD

Lung cancer

Smoking

Smoking cessation

Breast cancer

TBI before age 10 years (55-fold increase)

Screening from age 40 years

Consider screening from age 25 in high risk patients

Cervical cancer

Age >34

Chronic GVHD

Annual cervical examination beginning 1 year post-HCT

HPV vaccination in immunocompromised patients recommended by CDC

Cancers not increased in HCT survivors:

Further reading

Inamoto, Y., et al. (2015). "Secondary solid cancer screening following hematopoietic cell transplantation". Bone Marrow Transplant 50(8): 1013-1023.

Vaccination Prophylaxis post-SCT

The post-transplant vaccination schedule was updated in October 2018 to reflect recommendations made in the latest ECIL expert report. See the Post-Transplant Vaccination and Re-Immunisation Procedure (237835) and Post-Allogeneic HSCT Vaccination Prescription (237836) for details.

Autologous and allogeneic HCT recipients have very different immune recovery. However, due to lack of evidence, both groups generally share vaccination recommendations (Torda and Alexander 2009).

For most recipients of autologous HSCT, re-immunisation is unnecessary, with the exception of Pneumococcus and seasonal influenza vaccine.

Autologous HCT recipients – From 4 months post-transplant:

Below is a summary of the updated vaccination recommendation. Read the full procedure before prescribing.

Vaccination Policy post-SCT

About this Canterbury DHB document (202926):

Document Owner:

Andrew Butler (see Who's Who)

Issue Date:

December 2016

Next Review:

December 2018

Keywords:

Note: Only the electronic version is controlled. Once printed, this is no longer a controlled document. Disclaimer

Topic Code: 202926