Canterbury DHB
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 |
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 |
Smoking |
Smoking cessation |
|
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:
Inamoto, Y., et al. (2015). "Secondary solid cancer screening following hematopoietic cell transplantation". Bone Marrow Transplant 50(8): 1013-1023.
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.
Topic Code: 202926