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QoL and Patients' Care

Provision of long-term monitoring and late effects services following adult allogeneic haematopoietic stem cell transplant: a survey of UK NHS-based programmes

Bone Marrow Transplantation volume 52, pages 889–894 (2017)Cite this article

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Abstract

Despite international guidelines, optimal delivery models of late effects (LE) services for HSCT patients are unclear from the clinical, organizational and economic viewpoints. To scope current LE service delivery models within the UK NHS (National Health Service), in 2014, we surveyed the 27 adult allogeneic HSCT centres using a 30-question online tool, achieving a 100% response rate. Most LE services were led and delivered by senior physicians (>80% centres). Follow-up was usually provided in a dedicated allograft or LE clinic for the first year (>90% centres), but thereafter attrition meant that only ~50% of patients were followed after 5 years. Most centres (69%) had a standard operating procedure for long-term monitoring but access to a LE Multi-Disciplinary Team was rare (19% centres). Access to medical specialities necessary for LE management was good, but specialist interest in long-term HSCT complications was uncommon. Some screening (endocrinopathy, cardiovascular) was near universal, but other areas were more limited (mammography, cervical smears). Funding of extra staff and investigations were the most commonly perceived barriers to implementation of LE services. This survey shows variation in the long-term follow-up of allogeneic HSCT survivors within the UK NHS and further work is warranted to optimize effective, sustainable and affordable models of LE service delivery among this group.

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Acknowledgements

We acknowledge the contribution of both British Society of Blood and Marrow Transplantation staff and personnel in the 27 UK adult allogeneic HSCT centres in the execution of this survey. We also specifically thank Rachel Pearce and Julia Perry, BSBMT Registry, for their assistance in providing the registry data.

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Author notes

  1. British Society of Blood and Marrow Transplantation, London, UK.

Authors and Affiliations

  1. Department of Clinical Haematology, Oxford BRC Haematology Theme, Oxford University Hospitals NHS Foundation Trust, Oxford, UK

    A Hamblin & A Peniket

  2. Department of Clinical Oncology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK

    D M Greenfield

  3. Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK

    D M Greenfield & J A Snowden

  4. Department of Clinical Haematology, Leeds Teaching Hospitals NHS Trust, Leeds, UK

    M Gilleece

  5. Department of Haematology, Hammersmith Hospital, London, UK

    N Salooja

  6. Department of Haematological Medicine, King's College Hospital, London, UK

    M Kenyon

  7. Department of Immunology, Royal Free London NHS Foundation Trust and UCL Medical School, London, UK

    E Morris

  8. London Cancer Alliance, London, UK

    N Glover

  9. Anthony Nolan, London, UK

    P Miller & H Braund

  10. Department of Medicine, Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI, USA

    B E Shaw

  11. Department of Haematology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK

    J A Snowden

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on behalf of the British Society of Blood and Marrow Transplantation (BSBMT)

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Correspondence to A Hamblin.

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Hamblin, A., Greenfield, D., Gilleece, M. et al. Provision of long-term monitoring and late effects services following adult allogeneic haematopoietic stem cell transplant: a survey of UK NHS-based programmes. Bone Marrow Transplant 52, 889–894 (2017). https://doi.org/10.1038/bmt.2017.67

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