guidebook. - Fanconi Anemia Research Fund

218
Fanconi Anemia: Guidelines for Diagnosis and Management
Figure 3: Timing of Infections after Alternate Donor HSCT
Risks
-Nausea/vomiting/diarrhea
-Mouth sores
-Bacterial infections
-Fluid retention
-Hair loss
-Acute GvHD
-Viral/fungal infection
-Leukemia relapse (for
those transplanted with
leukemia)
-Late effects
post-transplant
-Cancers
Transplant 21 days 100 days
-Acute GvHD
-Viral/fungal infection
-Hemorrhagic cystitis
-Hyperglycemia (a
need for insulin)
-High blood pressure
-Graft failure
-EBV post-transplant
lymphoma disease
1 year 2 years
-Cataracts
-Thyroid insufficiency
-Leukemia relapse (for
those transplanted with
leukemia)
-Aseptic necrosis of
major joints
regarding the future need for transplantation has led
to renewed consideration of this option. It is unknown
whether the infusion of autologous hematopoietic stem
cells collected at an earlier time would benefit patients
as a method of rescue after graft rejection or as a source
of hematopoietic stem cells for future gene therapy or
multipotent adult stem cells for treatment of organs
other than the bone marrow. The transplant team should
consider the need for collecting autologous hematopoietic
cells.
Exposure to infection post-HSCT
Most transplant centers will expect the patient to remain
near the facility for a minimum of 100 days. While
major complications can occur after this period, the
first 100 days are considered the highest risk period for
the development of the immunologic complications
(i.e., graft rejection, GvHD, and opportunistic infection)
associated with alternate donor HSCT. During the