The objectives of the Outpatient Facility are: 1. To provide a common resource for Project 1-5 The facilities of the Outpatient Clinic (OPD) are essential for the acquisition of clinical data required to accomplish the aims of the various projects. It is in the OPD that assessments of sustained engraftment, tumors response, acute and chronic GVHD, manifestations of immunodeficiency, post-engraftment infections and other complications of bone marrow transplant are made. As well as clinical evaluations, the OPD provides a means for procuring blood and tissue specimens for multiple investigators. 2. To provide a systematic approach to the evaluation and management of late complications. The incidence and severity of multiple organ toxicities after BMT is under active investigation. A systematic approach to the follow-up of all patients will allow us to determine the contribution of multiple factors (such as age, preparative regimen, type of transplant, post-transplant immunosuppression) to the risk for the toxicities observed. In addition, it is anticipated that management approaches to the complications identified will be developed and investigated. 3. To prospectively evaluate chronic GVHD A systematic evaluation of patients with chronic GVHD will be carried out. A staging system for this condition will be developed as outlined in Project 2. Patients and clinical specimens for Phase II and Phase III therapeutic studies descried in Project 2 will be obtained in the OPD.
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