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Kes Grant transplant patient

Late Effects Practice Guidelines 

The Late Effects Practice Guidelines (LEPG) have been developed for transplant and non-transplant healthcare professionals to ensure the best care and implementation of late effects services in transplant centres, and to support you in your incredible work for patients. 

  • These guidelines have been developed by a working group and advisory group of transplant healthcare professionals, GPs and patient representatives, following research on current practice and need.
  • These guidelines apply to both autologous and allogeneic stem cell transplants unless otherwise stated.



Patient-reported changes in cognition after stem cell transplant (SCT) is common but there is limited understanding by transplant healthcare professionals or research into the management of symptoms.

The LEPG working group acknowledges that the guidelines are limited but see this as a first step to encouraging discussion with patients and documenting interventions.

There are plans for further research into the use of an appropriate cognition tool.


  • Discuss the potential effects of SCT treatment on cognition as early as possible, ideally pre-transplant.
  • Consider using a cognition screening tool for baseline assessment.
  • Routinely discuss/re-assess at 6 months, 1 year and annually at a minimum.


  • Provide information on the effects of stem cell transplant on cognition and advise on intervention and strategies that will improve symptoms.
  • Plan and document the interventions and strategies that will help the improvement and management of cognition.
  • Consider the effects of fatigue, mental wellbeing and lifestyle on cognition.
  • Consider referral to a cognitive rehabilitation service (if available), occupational therapist or neuropsychologist.

Practical Tools

Recovery Summaries


What is a recovery summary?

An Anthony Nolan recovery summary can be used to summarise a patient's recovery after transplant.

We recommend that this begins at six months post-transplant and is repeated at one year. It can then be used annually and can be used to follow up late effects of treatment.

As well as assessing physical recovery, a recovery summary will promote a holistic assessment, encouraging conversations around mental wellbeing, relationships, sexual health, finance and work.

If you are completing a recovery summary...

We know that each transplant centre will do things differently, so the recovery summaries can be used as a template.

You can download the recovery summary as a PDF and edit it onscreen. Or you can print it out and complete it by hand.

This recovery summary has been developed using well established international guidelines for caring for post-transplant patients. They have been user tested by patients and peer reviewed by transplant specialists.



*available soon

We’ll continue to update these guidelines. If you have any questions, please email 

Printed resources 

You can direct your patients to our tools and resources, full of specialist support designed specifically for those having a stem cell transplant.   

Posters, flyers & digital screens 

Our range of posters, flyers and other signposting tools are easy starting points to help let patients know that extra support is there, whenever they may need it. 

Information booklets 

Our informative, engaging booklets can help guide your conversations with patients. All are accredited by the PiF Tick quality mark, and many resources have been highly commended by the British Medical Association (BMA) Patient Information Awards

Find out more about our full range of services for patients.

Study Days 

You can learn how to provide the best possible care for stem cell transplant patients, and meet others working in similar roles, at our Anthony Nolan Study Days. 

Our Study Days invite a range of expert speakers to share the latest best practice on a range of issues, including: 

  • psychological support 
  • late effects 
  • Graft versus host disease (GvHD)  
  • CAR-T and other scientific developments 
  • palliative care. 

Specialist Study Days are available for: 

Anthony Nolan Study Days are accredited by the Royal College of Nursing and will contribute to your Core Professional Development (CPD) points. Networking opportunities to meet others in your field are built into each day.  


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Adoption Programme

We are looking to adopt a broad range of healthcare professionals from nurses and BMT coordinators, to occupational therapists and psychologists. By having your role adopted by Anthony Nolan, you can provide us with your specialist skills and knowledge working with stem cell transplant patients, while we can support you with your professional development. Together, we can provide the best possible care for patients.

Our funded clinical posts 

Since 2014, we have funded 18 healthcare professionals to raise the standard of post-transplant care across the country. We’re so proud to work alongside them.

Find out more

Contact us

If you have any clinical questions, we can link you up with our expert nurses, clinical psychologists and extended contacts. Together, we will continue to learn, grow, and improve the care given to stem cell transplant patients.