title: 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: Vancouver General Hospital, Vancouver, British Columbia, Canada. ymourad@bccancer.bc.ca
authors: Y R
authors: YR
authors: Abou-Mourad
authors: B C
authors: BC
authors: Lau
authors: M J
authors: MJ
authors: Barnett
authors: D L
authors: DL
authors: Forrest
authors: D E
authors: DE
authors: Hogge
authors: S H
authors: SH
authors: Nantel
authors: T J
authors: TJ
authors: Nevill
authors: J D
authors: JD
authors: Shepherd
authors: C A
authors: CA
authors: Smith
authors: K W
authors: KW
authors: Song
authors: H J
authors: HJ
authors: Sutherland
authors: C L
authors: CL
authors: Toze
authors: J C
authors: JC
authors: Lavoie
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006086:Graft vs Host Disease / Q000209:etiology / Q000401:mortality; D019337:Hematologic Neoplasms / Q000401:mortality / Q000628:therapy*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D006801:Humans; D007239:Infections / Q000209:etiology; D008297:Male; D008875:Middle Aged; D016609:Neoplasms, Second Primary / Q000401:mortality; D011379:Prognosis; D012008:Recurrence; D017741:Survivors; D019172:Transplantation Conditioning; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous / Q000009:adverse effects; D016896:Treatment Outcome