Prevalence and predictors of chronic health conditions after hematopoietic cell transplantation: a report from the Bone Marrow Transplant Survivor Study

Sun, Can Lan; Francisco, Liton; Kawashima, Toana; Leisenring, Wendy M.; Robison, Leslie L.; Baker, K. Scott; Weisdorf, Daniel J.; Forman, Stephen J.; Bhatia, Smita

doi:10.1182/blood-2009-06-229369

Cited by 219 publications

(195 citation statements)

References 30 publications

(34 reference statements)

Supporting

Mentioning

184

Contrasting

Unclassified

Order By: Relevance

“…2,16,17 This was not observed in a BMTSS study describing self-reported complications in mostly adult patients. 18 Child-specific adverse events like growth retardation might account for this difference. Abbreviation: BMD ¼ bone mineral density.…”

Section: Discussionmentioning

confidence: 99%

Health status of childhood leukemia survivors who received hematopoietic cell transplantation after BU or TBI: an LEA study

Bernard

Auquier

Herrmann

et al. 2014

Bone Marrow Transplant

View full text Add to dashboard Cite

The purpose of this multicenter study was to compare the long-term impact of a preparative regimen with either BUBU or TBI on health status and quality of life (QoL) in childhood acute leukemia survivors treated with hematopoietic SCT (HSCT). Two-hundred and forty patients were included. Sixty-six had received BU, while 174 had received TBI. Median follow-up from HSCT was 10.1 years. Multivariate analyses were performed to assess the occurrence of late effects according to treatment. QoL was assessed in 130 adults using SF-36 questionnaires. Patients developed fewer late complications after BU (2.35 vs 3.01, P ¼ 0.03) while the risk to present with at least one complication was equivalent in both groups (87.9% after BU and 93.1% after TBI, P ¼ 0.66). Detailed multivariate analyses revealed a lower risk of height growth failure (OR ¼ 0.2), cataract (OR ¼ 0.1) and iron overload (OR ¼ 0.2) after BU, and an increased risk of overweight (OR ¼ 3.9) and alopecia (OR ¼ 11.2). SF-36 mental and physical composite scores were similar in both treatment groups and proved significantly lower than French norms. Late effects induced by BU might differ from those experienced after TBI. Although less frequent, they are still of considerable importance and may affect patients' QoL.

show abstract

Section: Discussionmentioning

confidence: 99%

Health status of childhood leukemia survivors who received hematopoietic cell transplantation after BU or TBI: an LEA study

Bernard

Auquier

Herrmann

et al. 2014

Bone Marrow Transplant

View full text Add to dashboard Cite

show abstract

“…of life compared with patients who undergo ASCT. 32 Several randomized studies 24,25,[33][34][35][36] comparing allogeneic stem cell transplantation using HLA-identical siblings after a myeloablative conditioning regimen with ASCT and chemotherapy have reported better outcomes after allogeneic transplantation, but they have also consistently shown a decreased relapse incidence after ASCT compared with conventional chemotherapy. However, to date no randomized study has demonstrated the superiority of allogeneic transplantation using an alternative donor (unrelated or cord blood) over ASCT.…”

Section: Discussionmentioning

confidence: 99%

Intravenous busulfan for autologous stem cell transplantation in adult patients with acute myeloid leukemia: a survey of 952 patients on behalf of the Acute Leukemia Working Party of the European Group for Blood and Marrow Transplantation

et al. 2014

View full text Add to dashboard Cite

International audienceOral busulfan is the historical backbone of the busulfan+cyclophosphamide regimen for autologous stem cell transplantation. However intravenous busulfan has more predictable pharmacokinetics and less toxicity than oral busulfan; we, therefore, retrospectively analyzed data from 952 patients with acute myeloid leukemia who received intravenous busulfan for autologous stem cell transplantation. Most patients were male (n=531, 56%), and the median age at transplantation was 50.5 years. Two-year overall survival, leukemia-free survival, and relapse incidence were 67±2%, 53±2%, and 40±2%, respectively. The non-relapse mortality rate at 2 years was 7±1%. Five patients died from veno-occlusive disease. Overall leukemia-free survival and relapse incidence at 2 years did not differ significantly between the 815 patients transplanted in first complete remission (52±2% and 40±2%, respectively) and the 137 patients transplanted in second complete remission (58±5% and 35±5%, respectively). Cytogenetic risk classification and age were significant prognostic factors: the 2-year leukemia-free survival was 63±4% in patients with good risk cytogenetics, 52±3% in those with intermediate risk cytogenetics, and 37 ± 10% in those with poor risk cytogenetics (P=0.01); patients ≤50 years old had better overall survival (77±2% versus 56±3%; P<0.001), leukemia-free survival (61±3% versus 45±3%; P<0.001), relapse incidence (35±2% versus 45±3%; P<0.005), and non-relapse mortality (4±1% versus 10±2%; P<0.001) than older patients. The combination of intravenous busulfan and high-dose melphalan was associated with the best overall survival (75±4%). Our results suggest that the use of intravenous busulfan simplifies the autograft procedure and confirm the usefulness of autologous stem cell transplantation in acute myeloid leukemia. As in allogeneic transplantation, veno-occlusive disease is an uncommon complication after an autograft using intravenous busulfan

show abstract

“…[4][5][6] These problems include infections, second cancers, bone loss, and cardiovascular, pulmonary, renal, and endocrine dysfunction. 7,[10][11][12] Many factors contribute to the risks of late complications after HCT, including the antineoplastic treatments received before HCT, damage or adverse effects caused by the underlying disease, the chemotherapy and irradiation regimens used for conditioning before HCT, and medications such as corticosteroids, antibiotics, or calcineurin inhibitors used for years after HCT. Organ damage from infections or other complications during or after the transplantation process contribute to the increased risk of mortality.…”

Section: Medical Complications After Hctmentioning

confidence: 99%

“…Two thirds of adult long-term survivors have at least one chronic health condition, and approximately 20% have at least one severe or life-threatening condition. 7 Chronic graft-versus-host disease (GVHD) represents a unique late effect of allogeneic HCT that is not seen after other types of cancer treatment. This autoimmune-like complication can affect multiple organ systems and causes some of the most severe deficits in medical, symptom, and quality of life outcomes after HCT.…”

Section: Introductionmentioning

confidence: 99%

Delivering Care to Long-Term Adult Survivors of Hematopoietic Cell Transplantation

Syrjala

Martin

Lee

2012

JCO

102

View full text Add to dashboard Cite

A B S T R A C TThis review highlights long-term and late consequences of hematopoietic cell transplantation (HCT) as well as strategies to manage or prevent complications that are more prevalent after HCT than most other cancer treatments. Chronic graft-versus-host disease stands out as a unique late effect of allogeneic HCT that is not seen after other types of cancer treatment. However, many other complications seen after solid tumor treatments are also common after HCT, including infections, second cancers, bone loss, and cardiovascular, pulmonary, renal, and endocrine dysfunction. Symptoms and syndromes that are reported after HCT include sexual dysfunction, cognitive problems, fatigue, insomnia, musculoskeletal symptoms, emotional distress, anger, and depression. Addressing these complex potential or actual complications requires diligent routine health care to intervene early or, when possible, to prevent late complications. To accomplish early detection and prevention of life-threatening complications, HCT survivors should undergo an annual comprehensive physical examination that includes screening for functional and psychosocial consequences of treatment and encouraging healthy lifestyle behaviors. Clinicians can link survivors to numerous online, print, and video resources to help them advocate for their health needs.

show abstract

Prevalence and predictors of chronic health conditions after hematopoietic cell transplantation: a report from the Bone Marrow Transplant Survivor Study

Abstract: Long-term survival is now an expected outcome after hematopoietic cell transplantation (HCT).

Cited by 219 publications

References 30 publications

Health status of childhood leukemia survivors who received hematopoietic cell transplantation after BU or TBI: an LEA study

Health status of childhood leukemia survivors who received hematopoietic cell transplantation after BU or TBI: an LEA study

Intravenous busulfan for autologous stem cell transplantation in adult patients with acute myeloid leukemia: a survey of 952 patients on behalf of the Acute Leukemia Working Party of the European Group for Blood and Marrow Transplantation

Delivering Care to Long-Term Adult Survivors of Hematopoietic Cell Transplantation

Contact Info

Product

Resources

About