Health and functional status of adult recipients 1 year after allogeneic haematopoietic stem cell transplantation.
Increasing numbers of patients are surviving after allogeneic haematopoietic stem cell transplantation (SCT). Among these patients, a number of late complications have been described but few data on the risk factors of these long-term effects of SCT are available. We report the analysis on 105 adult patients, surviving free of haematological disease at a median time of 15 months after SCT. At the time of screening, 52% had returned to work, general health status was normal in 67% and 47% were sexually active. Female patient gender odds ratio (OR) 2.9 (P = 0.01) and age > 25 years (OR = 3.2, P = 0.02) were associated with non-return to work. Decreased general status was associated with chronic graft-versus-host disease (GvHD) (OR = 3.2, P = 0.009) and irradiation (OR = 3.6, P = 0.004). Sexual inactivity was associated with younger age (OR = 7.0, P = 0.0002) and chronic GvHD (OR = 3.3, P = 0.006). Risk factors for altered pulmonary function tests included previous smoking habits, irradiation and chronic GvHD. Obstructive lung disease was associated with a previous history of asthma. Sicca syndrome and conjunctivitis were increased in patients with previous acute GvHD and cataracts were less frequent in patients with aplastic anaemia. Persistent impaired hair re-growth was less frequent in patients who received irradiation (OR = 0.18, P = 0.002) but increased in patients with previous acute GvHD (OR = 5.3, P = 0.007). Microalbuminuria was more frequent in irradiated patients (OR = 9.4, P = 0.05). Raised cholesterol was associated with age (OR = 20.8, P < 0.001), previous acute GvHD (OR = 4.7, P = 0.03), steroid use (OR = 6.3, P = 0.001) and familial hypercholesterolaemia (OR = 4.4, P = 0.04). Decreased bone density was associated with chronic GvHD (OR = 3.9, P = 0.001). Thus, using routine tests in adult patients we were able to detect significant numbers of-non-symptomatic complications enabling early treatment.
Socié
G
G
Hematologie Greffe de Moelle, Hospital Saint Louis, Paris, France. gsocie@chu-stlouis.fr
Mary
J Y
JY
Esperou
H
H
Robert
D V
DV
Aractingi
S
S
Ribaud
P
P
Devergie
A
A
Toubert
M E
ME
Boudou
P
P
Cathelinau
B
B
Gluckman
E
E
Vexiau
P
P
D000208:Acute Disease; D000328:Adult; D000367:Age Factors; D001249:Asthma / Q000150:complications; D015519:Bone Density; D016009:Chi-Square Distribution; D002784:Cholesterol / Q000097:blood; D002908:Chronic Disease; D003075:Coitus; D005260:Female; D005500:Follow-Up Studies; D006086:Graft vs Host Disease; D019337:Hematologic Neoplasms / Q000532:radiotherapy / Q000534:rehabilitation* / Q000601:surgery; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D016013:Likelihood Functions; D008173:Lung Diseases, Obstructive / Q000209:etiology; D008297:Male; D016017:Odds Ratio; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects; D013997:Time Factors; D014184:Transplantation, Homologous
D002784:Cholesterol