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Allogenic blood and marrow transplant (allo-BMT) is an arduous treatment used increasingly for many life-threatening conditions. Recognition of the profound impacts of the long term and late effects is ever-growing, as is the healthcare workload (treatment burden) of survivorship.To quantify the treatment burden of long-term survival following allo-BMT, regarding the range of health services, therapies and investigations accessed by survivors.A large, multi-centre cross-sectional survey of adult allo-BMT survivors transplanted between 2000 and 2012 in Sydney, Australia. Participants completed six validated instruments and one purposed designed for the study, the Sydney Post BMT Study (SPBS), answering questions relating to medication use, medical treatments, referrals, assessments and frequency of hospital/clinic attendance.Of the 441 allo-BMT survivors, over a quarter who were more than 2 years post BMT attended the hospital clinic at least monthly, and 26.7% required a number of regular medical procedures (e.g. venesection, extracorpororeal photopheresis). Specialist medical and allied health referral was very common, and compliance with internationally recommended long-term follow-up (LTFU) care was suboptimal and decreased as time from BMT increased.Respondents reported a large medication (conventional and complementary), screening, assessment and health care burden.Treatment burden contributes significantly to the 'workload' of survivorship and can have a severe and negative impact on BMT survivors, carers and the healthcare system-making it difficult to comply with optimal care. Clinicians must be primed with skills to identify survivors who are overburdened by the health care required for survival and develop strategies to help ease the burden.

This review evaluates the latest information on the mobilisation of haemopoietic stem cells for transplantation, with the focus on what is the current best practice and how new understanding of the bone marrow stem cell niche provides new insights into optimising mobilisation regimens. The review then looks at the mobilisation of mesenchymal stromal cells, immune cells as well as malignant cells and what clinical implications there are.

Immunocompromised murine xenotransplantation models have become an important tool to study stem cell biology. One of the most common recipient strains used is the NOD/SCID mouse, which offers sufficient longevity to quantify moderate levels of engraftment. During pilot experiments, we noted incisor abnormalities 5 to 6 wk after nonmyeloablative doses of irradiation. Here we report a detailed examination of this phenomenon and propose possible explanations and management strategies. A total of 15 NOD/SCID mice received 3 Gy total body irradiation (TBI) and were monitored over 9 wk. A control group of 15 mice were treated in exactly the same way as the study mice except that they did not receive irradiation. A total of 9 TBI mice developed incisor abnormalities between days 40 and 50 after irradiation, resulting in rapid weight loss. No mice in the control group developed incisor abnormalities, however 3 were euthanized prematurely due to the development of thymic lymphoma. Upon development of incisor abnormalities and weight loss, 2 mice in the TBI group had their teeth trimmed and received soft food. Both mice made a rapid recovery and survived for the remainder of the study. The development of incisor abnormalities occurred in 2 substrains, and alterations in antibiotic use and supplementation of the vitamin content of feeds did not prevent the abnormalities. Investigators working with this model should be aware of this complication and modify protocols appropriately.