Bone Marrow Transplant

Learning Objectives: Fellows will learn how to work-up and subsequently manage patients admitted for bone marrow transplantation (BMT), peripheral blood stem cell transplantation (PBSCT), or their related complications. Fellows will progressively learn to: 1) Indicate stem cell transplantation (allogeneic, autologous) in newly diagnosed and relapsed/refractory patients. 2) Understand principles of HLA typing and donor selection. 3) Choose appropriate donors, taking into account disease, HLA typing, patient and donor-related information. 4) Choose preparative regimens for each patient based on patient and disease-related factors. 5) Recognize and manage common complications of transplantation (febrile neutropenia, infusion-related reactions, mucositis, and neurological and cardiac events). 6) Recognize and manage serious complications of transplantation, including sinusoidal obstructive syndrome (SOS) of the liver, pulmonary hemorrhage, atypical HUS, etc. 7) Understand rationale for choosing a specific immunosuppressive regimen in allogeneic transplantation. 8) Diagnose and stage acute and chronic graft vs. host disease, and understand principles of management. 9) Utilize comorbidity scoring systems in decisions to proceed (or not) with transplantation. 10) Educate patients about potential shortand long-term complications associated with BMT/PBSCT. 11) Perform diagnostic and therapeutic procedures (bone aspirate/biopsy, lumbar puncture, and tap of Ommaya/Hickham catheters with and without intra-thecal chemotherapy), if procedures are performed. May wish to use separate bone marrow biopsy evaluation tool. 12) Work within a multi-disciplinary team to exhibit excellent interpersonal and communication skills, professionalism, and effective hand-offs.