What follow up (extended care) is needed after treatment?

What follow-up is needed after treatment? So what treatments are required after the initial treatment? So what I would say for an allogeneic bone marrow transplant, it's like all the bad things that happen during the transplant. So if you get graft-versus-host disease where the patient, the donor's immune system starts to attack you, you have to deal with that. That's an ongoing treatment. If you have infections because your immune system gets blown away during the transplant, you're going to have to deal with that. So it's really like all the things after bone marrow transplant are almost always because of the bone marrow transplant. So it's just the side effects of what you get from that. For treatments like hypomethylating agents, in that case, that treatment is typically a chronic treatment. So you get that like every month. You just keep going and you keep do it until number one, it doesn't work anymore. Or number two, you can't tolerate it, right? And that's usually your blood counts are getting too low. So here again, I think it's really individualized in terms of side effects of whatever the therapy you get. So it just depends on that more than anything else. With an allogeneic transplant, after the transplant is done, typically what you're going to do is you could be on immunosuppression to prevent your body from rejecting the new bone marrow you got and to prevent the new cells you got from attacking you. So immunosuppression does both things. So you might be on that for three months after the transplant. You might be on that for six months after the transplant. You might be on that for a year after the transplant. If you get graft-first associated disease, you might be on that for a lot longer than that. So that's the therapy that happens over time. With a lot of allogeneic bone marrow transplants now for MDS, what we're trying to do is we do the transplant and then we do something to try to prevent the MDS from coming back. So we'll do maintenance therapy. So you might, in a lot of cases, get a hypomethylating agent after the transplant. You might do that for a year. You might do that for six months. It's variable in time. But I would say the long-term treatments are either complications of the transplant here again or something like maintenance to try to prevent the disease from coming back. Yeah, so I think that the further you go out, the less likely you are to relapse and the less likely you have problems. So what I would say is something like for the first year, I might see someone every day for the first month. Right? Then I might see them twice a week for the next months. And then I might see them once a month for the rest of the year. And then after that, I might see them every three months. And then I might see them every six months. And then I might see them once a year. Usually if there's no complications by the time you get to year five, then I usually only see people once a year. And oftentimes, I'll send them back to someone who's a primary caregiver. Has there been no complications? Has there been no relapse? I'll send them back to them and have them sort of take care of the patient. MDS patients should be watched closely by a hematologist, oncologist who's comfortable caring for patients with MDS and leukemias. It's a rare disease and it's important to know that the physician taking care of you knows what they're doing and is able to monitor you carefully. Follow-up usually means checking blood counts over time. Some patients need bone marrow biopsies periodically as well.