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Table 12. Spleen Late Effects

Predisposing Therapy Immunologic Effects Health Screening/Interventions 
GVHD = graft-versus-host disease; HSCT = hematopoietic stem cell transplantation; IgA = immunoglobulin A; T = temperature.
Radiation impacting spleen; splenectomy; HSCT with currently active GVHDAsplenia/hyposplenia; overwhelming post-splenectomy sepsisBlood cultures during febrile episodes (T >38.5°C); empiric antibiotics
HSCT with any history of chronic GVHDImmunologic complications (secretory IgA deficiency, hypogammaglobulinemia, decreased B cells, T cell dysfunction, chronic infections [e.g., conjunctivitis, sinusitis, and bronchitis associated with chronic GVHD])History: chronic conjunctivitis, chronic sinusitis, chronic bronchitis, recurrent or unusual infections, sepsis
Exam: attention to eyes, nose/sinuses, and lungs