The National Comprehensive Cancer Network (NCCN) recently issued new guidelines on best practices in evaluating patients for hematopoietic cell transplantation, as well as how to manage complications associated with the procedure.
“Establishing NCCN Guidelines for hematopoietic cell transplantation is a key accomplishment in the management of blood cancers,” Ayman A. Saad, MD, chair of the NCCN Guidelines® Panel for HCT. “The current version of the guidelines addresses both pre-transplant evaluation and the management of a common complication: graft versus host disease (GVHD). Given the diversity of practice and expertise, we believe these guidelines will provide a pivotal tool for learning about the continuously updated therapy landscape in HCT.”
The guidelines are intended to provide recommendations that reflect upon the latest evidence and consensus from experts across its 28 leading academic cancer centers. In this instance, they are meant to provide an algorithmic pathway for a systematic approach to allogeneic transplantation across several different cancer types, such as leukemia, lymphoma, and multiple myeloma.
“We hope this will help streamline clinical practices and educate new generations of physicians-in-training,” said Saad, who is also professor of clinical medicine, The Ohio State University Comprehensive Cancer Center – James Cancer Hospital and Solove Research Institute.
One aspect of importance in the guidelines is how to evaluate a potential transplant recipient to determine if the patient is an appropriate candidate for the procedure. Alison W. Loren, MD, MSCE, member of the NCCN Guidelines Panel for HCT, noted that being able to identify those who would benefit from HCT could save many lives.
“Early referral for consideration of HCT can be life-saving, so we strongly encourage all oncologists to take a look at these guidelines and refer any possible candidates to transplant centers for evaluation,” Loren said, who is also director, blood and marrow transplant, Cell Therapy & Transplant Program, Abramson Cancer Center of the University of Pennsylvania.
“We also urge oncologists who may be caring for patients after HCT to familiarize themselves with the varied manifestations of GVHD—a very common and significant post-transplant complication—and to consult with transplant providers to optimize their ongoing care,” she added. “The guidelines explain how to diagnose and treat this condition in order to achieve the best possible outcomes.”
Marcos de Lima, MD, vice-chair of the NCCN Guidelines Panel for HCT, agreed, highlighting the importance of guidelines being issued in tandem with the increase of donors over the years.
“Thankfully, the number of blood and bone marrow donors has increased substantially in just the past decade. When you combine the National Marrow Donor Program®/Be The Match® registry adult donors with cord blood donors and relatives (matched and mismatched), we are now able to perform this potentially cancer-curing procedure on significantly more patients than we could in the past,” said Lima, who is also Professor of Medicine, Case Comprehensive Cancer Center and University Hospitals of Cleveland. “That’s why it’s so important to set standards for preventing and treating common adverse events and infections.”
National Comprehensive Cancer Network. New NCCN Guidelines Debut to Manage Complications and Improve Readiness for Stem Cell Transplant Recipients. Available from: https://www.nccn.org/about/news/newsinfo.aspx?NewsID=1756. Accessed November 4, 2019.