Long-term outcome after allo-SCT: close follow-up on a large cohort treated with myeloablative regimens.

Abstract

We analyzed the late outcomes of 429 long-term survivors post allogeneic hematopoietic SCT (allo-HSCT) who received transplant in our center between 1981 and 2002, and were free of their primary disease for > or =2 years after allo-HSCT. Late recurrent primary malignancy was found in 58 (13.5%) patients and was the primary cause of late death. A total of 37 (8.6%) patients died of non-relapse causes at a median of 5.5 years (range, 2-15.6 years) post allo-HSCT. The major non-relapse causes of death were chronic GVHD (cGVHD), secondary malignancy and infection. The probabilities of OS and EFS were 85% (95% cumulative incidence (CI) (81-89%)) and 79% (95% CI (74-83%)) at 10 years, respectively. Long-term allo-HSCT survivors were evaluated for late complications (median follow-up, 8.6 years (range, 2.3-22.8 years)). cGVHD was diagnosed in 196 (53.1%) survivors. The endocrine and metabolic complications were hypogonadism in 134 (36.3%) patients, osteopenia/osteoporosis in 90 (24.4%), dyslipidemia in 33 (8.9%), hypothyroidism in 28 (7.6%) and diabetes in 28 (7.6%). Hypertension was diagnosed in 79 (21.4%), renal impairment in 70 (19.0%), depression in 40 (10.8%) and sexual dysfunction in 33 (8.9%) survivors. We conclude that in patients who receive allo-HSCT as treatment for hematological malignancy and who are free of their original disease 2 years post transplant, mortality is low and the probability of durable remission is high. Lifelong surveillance is recommended.

• Authors: Y R Abou-Mourad, B C Lau, M J Barnett, D L Forrest, D E Hogge, S H Nantel, T J Nevill, J D Shepherd, C A Smith, K W Song, H J Sutherland, C L Toze, J C Lavoie
• Journal: Bone marrow transplantation (Bone Marrow Transplant) Vol. 45 Issue 2 Pg. 295-302 (Feb 2010) ISSN: 1476-5365 [Electronic] England
• PMID: 19597425 (Publication Type: Journal Article)

Topics

• Adolescent
• Adult
• Female
• Follow-Up Studies
• Graft vs Host Disease (etiology, mortality)
• Hematologic Neoplasms (mortality, therapy)
• Hematopoietic Stem Cell Transplantation (adverse effects)
• Humans
• Infections (etiology)
• Male
• Middle Aged
• Neoplasms, Second Primary (mortality)
• Prognosis
• Recurrence
• Survivors
• Transplantation Conditioning
• Transplantation, Autologous
• Transplantation, Homologous (adverse effects)
• Treatment Outcome