Long-Term Follow-Up

Once you are discharged from the Blood and Marrow Transplant (BMT) Clinic you become part of the long-term follow-up program. Typically, patients are discharged one month after an autologous (using your own cells) transplant and three months after an allogeneic (donor) transplant. 

Blood and marrow transplant (BMT) and the related procedures and steps that are needed to prepare you for BMT are intense, and they can impact many systems of your body. Some issues may go away on their own after a few weeks or months. Others may not. 

The LTFU Program helps you and your local physician prevent, manage and treat long-term effects of BMT and consider options if your original disease returns. 

The LTFU team can help with any complications that may affect your quality of life and/or increase your risk for developing cancer in the future. Here are some of the ways we can help you: 

• Conditioning-related complications: For example, problems with your immune system, skin, internal organs or emotional health issues. 

• Transplant complications: These can include ongoing tiredness, sexuality issues and trouble concentrating.  

• Graft-versus-host disease (GVHD): GVHD can happen if you had an allogeneic (donor) transplant. Fred Hutch has a team of world-renowned experts who can help manage GVHD if you develop it.  

• Cancer recurrence: Your local physician will perform regular checkups in order to detect any issues, such as a recurring cancer, as early as possible. If your cancer comes back, our LTFU experts can meet with you and your local physician to discuss treatment options. 

Before you can be discharged and join LTFU, we give you a complete transplant departure evaluation to: 

• Check the status of the disease for which you had your transplant 
  
• Test you for chronic graft-versus-host disease (GVHD), if you had an allogeneic (donor) transplant 
• Check how well the transplanted cells are working 
• Assess your immune system and your body’s ability to fight infection 

You also will have a class with an LTFU nurse to go over: 

• What you need to know before going home 
  
• Signs to watch for that may mean you have a problem 
  
• How to prevent and manage late effects (problems that happen after treatment) 
  

Telephone consultations: The LTFU nurses provide telephone consultations for you and your physician. Our experienced staff can help with issues such as:  

• How to manage late effects (problems that happen after treatment) 
  
• The newest treatment options or clinical trials that might help you 
  
• Care options if your original disease comes back 
  

In-person care: LTFU provides in-person, specialized care at the LTFU Clinic on the sixth floor of the South Lake Union clinic. 

• Most allogeneic (donor) transplant LTFU patients return for at least one in-person annual evaluation. 
  
• If you have GVHD, you will come to the clinic more than once a year. If you have chronic GVHD, you may need to come in several times a year. 
  

LTFU Research Program: If you decide to join, we will follow up on your post-transplant experience and listen to your feedback. By being part of the program, you will help others like you who are going through BMT and help us build our knowledge about life and care after BMT. 

Patient and caregiver resource manual: This manual includes detailed information on how to manage your care at home after your BMT. 

Class: Before you go home after your BMT you will have a long-term follow-up class led by a registered nurse (RN) that reviews:

• What you need to know before going home 
• Signs to watch for that may mean you have a problem 
• How to prevent and manage late effects (problems that happen after treatment)  

During business hours, we check email throughout the day. If an email is received outside of operating hours (see below), our staff will check it the morning of the next business day, after we open at 8 am. 

Yes. Voicemail is available after hours. We also check messages throughout the day during business hours.

We try our best to respond to calls and emails within 24 hours; however, we cannot guarantee this response time. All calls and emails are prioritized by the urgency of the problem. If your problem is not urgent, our BMT experts may discuss your case at the LTFU rounds, a meeting with the LTFU physician that happens three times a week.