Today, the National Comprehensive Cancer Network® (NCCN®) published new NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Hematopoietic Cell Transplantation (HCT), also known as stem cell transplant or historically as bone marrow transplant. This new resource provides step-by-step information on best practices in evaluating patients for hematopoietic cell transplantation and managing complications afterwards. This type of specialized treatment is increasingly common, occurring approximately 22,000 times a year in the United States in people with various malignancies, most commonly for blood-related cancers.
Establishing NCCN Guidelines for Hematopoietic Cell Transplantation is a key accomplishment in the management of blood cancers. 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. We hope this will help streamline clinical practices and educate new generations of physicians-in-training."
Ayman A. Saad, MD, Professor of Clinical Medicine, The Ohio State University Comprehensive Cancer Center – James Cancer Hospital and Solove Research Institute, Chair of the NCCN Guidelines® Panel for HCT
The guidelines provide recommendations on how to evaluate a potential transplant recipient to determine if the patient is an appropriate candidate for the procedure, and how to best manage different manifestations of post-transplant GVHD. They reflect the latest evidence and consensus from foremost experts across the 28 leading academic cancer centers that comprise NCCN, including hematologists/oncologists, transplant-specific practitioners, and infectious disease specialists.
"These guidelines provide an algorithmic pathway for a systematic approach to allogeneic (donor) transplantation across several different cancer types including leukemia, lymphoma, and multiple myeloma," explained Marcos de Lima, MD, Professor of Medicine, Case Comprehensive Cancer Center and University Hospitals of Cleveland, Vice-Chair of the NCCN Guidelines Panel for HCT. "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 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. That's why it's so important to set standards for preventing and treating common adverse events and infections."
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. 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. The guidelines explain how to diagnose and treat this condition in order to achieve the best possible outcomes."
Alison W. Loren, MD, MSCE, Director, Blood & Marrow Transplant, Cell Therapy & Transplant Program, Abramson Cancer Center of the University of Pennsylvania, Member of the NCCN Guidelines Panel for HCT
The NCCN Guidelines for Hematopoietic Cell Transplantation are available free-of-charge for non-commercial use at NCCN.org and via the recently improved Virtual Library of NCCN Guidelines® App for smartphone and tablet. NCCN will continue expanding blood cancer resources through continuous updates to the HCT guidelines, along with upcoming new NCCN Guidelines for Histiocytosis, Myeloid/Lymphoid Neoplasms, Pediatric B-Cell Lymphomas, and Pediatric Hodgkin Lymphoma.