II. Indications
- Leukemia management
- Bone Marrow Suppression following high dose chemo
III. Advantages: Compared with Bone Marrow Transplant
- More effective than Bone Marrow Transplant
- Much easier to harvest
- Identify CD34 Antigen via Monoclonal Antibody
- Small volume of peripheral stem cells effective
- Greater disease free survival than Bone Marrow
- Shorter hospitalization (2 weeks rather than 3 weeks)
- Much less costly
IV. Management: Surveillance of survivors treated with Hematopoietic Stem Cell Transplantation
-
Complete Blood Count with differential
- Every 1-2 months for the first year THEN
- Every 3-6 months for the second year THEN
- Every 6 to 12 months
- Testing at one year following Stem Cell Transplantation
- Bone density (DEXA Scan)
- Ophthalmic exam
- Consult Hematology for testing testing at one year
- Previously one year labs have included CD4 Cell Count, Immunoglobulin level
- See annual lab testing below
- Annual lab testing
- Comprehensive metabolic panel
- Includes serum Electrolytes, Serum Glucose, Serum Creatinine, Blood Urea Nitrogen and Liver Function Tests
- Also obtain Serum Magnesium and Serum Phosphorus
- Urinalysis and Urine Microalbumin
- Serum Ferritin
- Other labs performed as needed
- Thyroid Stimulating Hormone
- Vitamin D
- Hemoglobin A1C
- Serum Testosterone in males
- Follicle Stimulating Hormone (FSH) and Luteinizing Hormone (LH) in females
- Comprehensive metabolic panel
- Routine Health Maintenance
- Annual physical exam
- Growth Assessment
- Dental exams at least annually
- Annual audiology exam
- Routine cancer screening including full body skin exam
- Immunizations
- Postpone Live Vaccines for at least 24 months after Hematopoietic Stem Cell Transplant
- Inactivated Vaccines may be given as early as 6 to 12 months after Hematopoietic Stem Cell Transplant
-
Pulmonary Function Test indications
- If abnormal prior to treatment