II. Indication

  1. Leukemia management
  2. Bone Marrow Suppression following high dose chemo

III. Advantages: Compared with Bone Marrow Transplant

  1. More effective than Bone Marrow Transplant
  2. Much easier to harvest
    1. Identify CD34 Antigen via Monoclonal Antibody
  3. Small volume of peripheral stem cells effective
  4. Greater disease free survival than Bone Marrow
  5. Shorter hospitalization (2 weeks rather than 3 weeks)
  6. Much less costly

IV. Management: Surveillance of survivors treated with Hematopoietic Stem Cell Transplantation

  1. Complete Blood Count with differential
    1. Every 1-2 months for 3 years THEN
    2. Every 3-6 months for up to 5 years THEN
    3. Annually
  2. Testing at one year following Stem Cell Transplantation
    1. CD4 Cell Count
    2. Immunoglobulin level
    3. Bone density
    4. Ophthalmic exam
  3. Annual lab testing
    1. Comprehensive metabolic panel
      1. Includes serum Electrolytes, Serum Glucose, Serum Creatinine, Blood Urea Nitrogen and Liver Function Tests
    2. Thyroid Stimulating Hormone
    3. Urinalysis and Urine Microalbumin
    4. Serum Ferritin
    5. Vitamin D
    6. Hemoglobin A1C
    7. Serum Testosterone in males
    8. Follicle Stimulating Hormone (FSH) and Luteinizing Hormone (LH) in females
  4. Routine Health Maintenance
    1. Dental exams at least annually
    2. Routine cancer screening
    3. Immunizations
  5. Pulmonary Function Test indications
    1. If abnormal prior to treatment

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