Late effects and quality of life of childhood cancer survivors: Part 1. Impact of stem cell transplantation

Abstract

To examine the late effects and health-related quality of life among childhood cancer survivors (CCS) after stem cell transplantation (SCT), we performed a cross-sectional survey using self-rating questionnaires. The subjects were divided into 3 groups: SCT-treated CCS, CCS treated without SCT, and the general population who matched for age, gender, residential area, and work status with the CCS. We analyzed the questionnaires of 185 CCS and 1,000 control participants. The median ages of CCS at diagnosis and survey were 8 and 22 years, respectively. The mean final heights of male and female participants were significantly lower for SCT-treated CCS than for CCS treated without SCT and the controls. Among the SCT-treated CCS, >40% were underweight (BMI < 18.5). Late effects were observed in 78% of SCT-treated CCS versus 45% of CCS treated without SCT. Multivariate analysis revealed that >15 years' duration after therapy completion (OR 2.95; p = 0.014), solid tumors (4.31; p = 0.040), radiotherapy (2.82; p = 0.009), recurrence (4.22; p = 0.017), and SCT (3.39; p = 0.014) were significant risk factors for late effects. Subjective symptoms were significantly frequent in SCT-treated CCS. Physical dysfunction, psychological stress, and social adaptation problems were observed in >70% of SCT-treated CCS.

Late effects and quality of life of childhood cancer survivors: Part 2. Impact of radiotherapy

“…The demographic data of the participants were reported previously [5,12]. Table 2 shows the characteristics of CCS with or without RT.…”

“…The adjusted ORs of RT for adverse outcomes were estimated employing logistic regression analysis. As adjusted variables, we selected independent, significant risk factors like SCT, solid tumors, recurrence, and duration after therapy completion, as shown in our previous article [5]. To avoid multi-collinearity, we assessed associations between predictors in a pairwise fashion.…”

“…The inclusion and exclusion criteria for participants and the methods were reported previously [5,12]. Briefly, the subjects were divided into 3 groups: CCS treated with RT, CCS treated without RT, and a general population as a control group.…”

“…In our previous report, multivariate analysis revealed that not only SCT [odds ratio (OR) 3.39, p = 0.014] but also radiotherapy (RT) (OR 2.8, p = 0.009) were independent significant risk factors for late effects [5]. Many articles have demonstrated that one of the most important risk factors for late effects in CCS is RT [4,[6][7][8][9].…”

“…We reported that a short stature (\-2 SD) and being underweight (BMI \ 18.5) were observed frequently in CCS treated with stem cell transplantation (SCT), and that late effects were noted in 78% of SCT-treated CCS versus 45% of CCS treated without SCT [5]. In our previous report, multivariate analysis revealed that not only SCT [odds ratio (OR) 3.39, p = 0.014] but also radiotherapy (RT) (OR 2.8, p = 0.009) were independent significant risk factors for late effects [5].…”