Abstract
Travel activity and travel-related risks of patients after allogeneic haematopoietic stem cell transplantation (allo-HSCT) remain largely unknown. The aim of our study was to examine travel activity after allo-HSCT including travel behaviour and travel patterns. We analysed travel characteristics of allo-HSCT recipients by using a retrospective cross-sectional survey. Allo-HSCT patients were asked to complete a questionnaire during their annual health visits from 2010 to 2012. Overall, 118/153 (77%) participating patients reported travel activity for a total of 201 travelling episodes. Travellers versus non-travellers were receiving immunosuppressive treatment in 35.6% versus 65.7% (p=0.002), and had graft-versus-host-disease (GvHD) in 52.5% versus 62.9% (p=0.17). In a multivariate analysis, the time between the transplantation and the survey was the only factor associated with travel activity (p<0.0001) and taking pretravel advice (p<0.0001). In 34.8% of travel episodes pretravel advice was sought. Patients with pretravel advice reported travel-related symptoms more frequently. Minor respiratory (27/201) and gastrointestinal (23/201) symptoms were most frequently indicated. Four percent (8/201) of the patients were hospitalised while travelling. We conclude that travelling after allo-HSCT is frequent and linked to the time since transplantation. We could not define specific risks for any destination. Nevertheless, pretravel advice and preparation are highly recommended for immunosuppressed patients.
Highlights
Travelling is a challenge for immunosuppressed patients owing to the complex medical conditions and an increased risk of travel-associated infections
Allo-HSCT patients were asked to complete a questionnaire during their annual health visits from 2010 to 2012
The time between the transplantation and the survey was the only factor associated with travel activity (p
Summary
Travelling is a challenge for immunosuppressed patients owing to the complex medical conditions and an increased risk of travel-associated infections. After allo-HSCT, immunosuppression is often prolonged, complex and associated with an increased risk of infectious diseases [8, 9]. To the best of our knowledge, to date no guidelines regarding the time and specific conditions for travelling after allo-HSCT have been published. For SOT recipients travel to high-infection-risk destinations (Africa, Asia, Middle and South America) should be postponed for at least 1 year post-transplant according to the current recommendations of the Centres for Disease Control and Prevention (CDC) [12]. The CDC considers the presence of active GvHD, the need of on-going immunosuppressive treatment and a post-transplant time less than 2 years as conditions of severe immunosuppression [12].
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