Return to School Practices After Hematopoietic Cell Transplantation: A Survey of Transplant Centers in the United States

Abstract

Abstract Current literature lacks transplant center recommendations on return-to-school timing and related support for hematopoietic cell transplant (HCT) survivors. We describe findings from a two-phase, cross-sectional, web-based survey: In Phase I, medical directors of pediatric HCT centers from the National Marrow Donor Program/ Be The Match Registry were asked regarding the availability of a return to school standardized operating procedure (SOP). In Phase II, HCT physician members of the Pediatric Transplantation and Cellular Therapy Consortium were approached to study inter-physician practice variability regarding return to school post-HCT, factors affecting their decision-making, and support provided by HCT centers for return to school. Out of 46 respondents in Phase I (55% response rate), 28 (61%) reported having a SOP. Wide variations in recommendations were noted in 12 received SOPs. In Phase II, 122 physicians (60 centers) responded (30.6% response rate). The majority (60%) recommended autologous HCT recipients return to school within 6 months post-HCT but 65% recommended allogeneic HCT recipients return to school after 6 months or once off immunosuppression. Response variations were also noted within HCT centers. The top factors considered by physicians were health complications and graft vs. host disease/ immune suppression for autologous and allogeneic HCT recipients, respectively. There is a lack of consensus within and across HCT centers regarding recommended timing of HCT survivors’ return to school. Guidelines to standardize the return to school process are needed to ensure patient safety and re-integration into school to foster academic and social development for pediatric HCT recipients.