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Survivorship
The individual with a newly diagnosed hematologic malignancy begins a journey with the urgent goal to cure the malignancy. That goal can be met for an ever-increasing number of these individuals, and hematopoietic cell transplant (HCT) plays an important role…
Symptom Management and Palliative Care in Hematologic Malignancies
Introduction Patients with hematologic malignancies experience complex physical and psychosocial symptoms, affecting their quality of life (QOL). Patients may undergo specific high-risk procedures such as hematopoietic cell transplantations (HCTs) and chimeric antigen receptor T-cell (CAR-T-cell) therapies, which further predispose them…
Miscellaneous Complications of Chimeric Antigen Receptor T-Cell Therapy
Hemophagocytic Lymphohistiocytosis Hemophagocytic lymphohistiocytosis (HLH) is a rare and potentially life-threatening complication of autologous anti-CD19 chimeric antigen receptor (CAR) T-cell therapy, reported in 1% to 3.5% of patients with relapsed or refractory (r/r) large B-cell lymphoma (LBCL). In the ZUMA-1…
Neurologic Complications of Chimeric Antigen Receptor Therapy
Epidemiology and Pathogenesis Beginning in 2017, there has been a steady increase in use of U.S. Food and Drug Administration (FDA)-approved chimeric antigen receptor (CAR) T-cell products for refractory relapsed hematologic tumors. Various host factors like disease burden, pretreatment inflammation,…
Cytokine Release Syndrome Following CD19 Directed Chimeric Antigen Receptor T-Cell Therapy
Introduction T-cells genetically engineered to express a chimeric antigen receptor (CAR) that targets a specific tumor antigen have become a major clinical tool to treat several high-risk hematologic malignancies. Since the development of the first CAR T-cell in 1989, remarkable…
Miscellaneous Complications of Hematopoietic Cellular Transplantation
Introduction Advancements in hematopoietic cell transplantation (HCT) have been associated with expanding indications and eligibility, alternative donor options, and improvement in overall survival (OS). Yet, HCT for hematologic malignancies are still associated with the potential for significant toxicities that may…
Graft-Versus-Host Disease
Introduction Graft-versus-host disease (GVHD) is the leading cause of nonrelapse mortality (NRM) beyond day 100 in recipients of human leukocyte antigen (HLA)-matched sibling donor (MSD) hematopoietic cell transplantation (HCT), and the second leading cause of NRM in recipients of HLA-matched…
Graft Failure After Hematopoietic Cell Transplantation
Introduction and Historical Perspective The first hematopoietic cell transplantation (HCT) was performed in 1956 and demonstrated neutrophil recovery and transient donor cell engraftment, as documented by red cell engraftment. However, in these original transplants only two of the six reported…
Management of Infections in Stem Cell Transplant Recipients
Infections are a frequent cause of morbidity and mortality in recipients of hematopoietic cell transplant (HCT). Multiple studies have documented a significant and progressive improvement in outcomes of recipients of HCT over the last two decades because of a decline…