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

YR Abou-Mourad, BC Lau, MJ Barnett… - Bone marrow …, 2010 - nature.com
YR Abou-Mourad, BC Lau, MJ Barnett, DL Forrest, DE Hogge, SH Nantel, TJ Nevill…
Bone marrow transplantation, 2010nature.com
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⩾ 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) …
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⩾ 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.
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