title: Late effects and quality of life of childhood cancer survivors: part 1. Impact of stem cell transplantation.
abstract: To examine the late effects and health-related quality of life among childhood cancer survivors (CCS) after stem cell transplantation (SCT), we performed a cross-sectional survey using self-rating questionnaires. The subjects were divided into 3 groups: SCT-treated CCS, CCS treated without SCT, and the general population who matched for age, gender, residential area, and work status with the CCS. We analyzed the questionnaires of 185 CCS and 1,000 control participants. The median ages of CCS at diagnosis and survey were 8 and 22 years, respectively. The mean final heights of male and female participants were significantly lower for SCT-treated CCS than for CCS treated without SCT and the controls. Among the SCT-treated CCS, >40% were underweight (BMI < 18.5). Late effects were observed in 78% of SCT-treated CCS versus 45% of CCS treated without SCT. Multivariate analysis revealed that >15 years' duration after therapy completion (OR 2.95; p = 0.014), solid tumors (4.31; p = 0.040), radiotherapy (2.82; p = 0.009), recurrence (4.22; p = 0.017), and SCT (3.39; p = 0.014) were significant risk factors for late effects. Subjective symptoms were significantly frequent in SCT-treated CCS. Physical dysfunction, psychological stress, and social adaptation problems were observed in >70% of SCT-treated CCS.
authors.affiliation: Department of Pediatrics, St. Luke's International Hospital, 10-1 Akashi-cho, Chuo-ku, Tokyo, 104-0044, Japan. yaishida@luke.or.jp
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Ishida
authors.forename: Misato
authors.initials: M
authors.lastname: Honda
authors.forename: Shuichi
authors.initials: S
authors.lastname: Ozono
authors.forename: Jun
authors.initials: J
authors.lastname: Okamura
authors.forename: Keiko
authors.initials: K
authors.lastname: Asami
authors.forename: Naoko
authors.initials: N
authors.lastname: Maeda
authors.forename: Naoko
authors.initials: N
authors.lastname: Sakamoto
authors.forename: Hiroko
authors.initials: H
authors.lastname: Inada
authors.forename: Tsuyako
authors.initials: T
authors.lastname: Iwai
authors.forename: Kiyoko
authors.initials: K
authors.lastname: Kamibeppu
authors.forename: Naoko
authors.initials: N
authors.lastname: Kakee
authors.forename: Keizo
authors.initials: K
authors.lastname: Horibe
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000628:therapy*; D011788:Quality of Life; D033581:Stem Cell Transplantation; D011795:Surveys and Questionnaires; D017741:Survivors; D055815:Young Adult
references.citation: J Clin Oncol. 2009 May 10;27(14):2405-14
references.pmid: 19289611
references.citation: J Clin Endocrinol Metab. 2004 Dec;89(12):5981-6
references.pmid: 15579747
references.citation: Endocr J. 2008 Dec;55(6):1055-63
references.pmid: 18719293
references.citation: Int J Hematol. 2002 Aug;76 Suppl 2:15-28
references.pmid: 12430895
references.citation: Bone Marrow Transplant. 2010 Jan;45(1):79-85
references.pmid: 19421172
references.citation: N Engl J Med. 2006 Oct 12;355(15):1572-82
references.pmid: 17035650
references.citation: Blood. 2003 May 1;101(9):3373-85
references.pmid: 12511420
references.citation: J Clin Oncol. 2009 May 10;27(14):2308-18
references.pmid: 19364948
references.citation: Horm Res. 2008;69(2):65-74
references.pmid: 18059086
references.citation: Bone Marrow Transplant. 2009 Mar;43(6):461-8
references.pmid: 18936733
references.citation: Lancet Oncol. 2010 Apr;11(4):331-8
references.pmid: 20117965
references.citation: Br J Haematol. 2002 Jul;118(1):3-22
references.pmid: 12100125
references.citation: J Pediatr Oncol Nurs. 2007 Mar-Apr;24(2):106-15
references.pmid: 17332424
references.citation: Bone Marrow Transplant. 2007 Apr;39(8):483-90
references.pmid: 17334386
references.citation: Support Care Cancer. 2009 Sep;17(9):1169-75
references.pmid: 19139926
references.citation: Cancer. 2005 Apr 15;103(8):1730-9
references.pmid: 15761876
references.citation: Biol Blood Marrow Transplant. 2006 Feb;12(2):138-51
references.pmid: 16443512
references.citation: Br J Haematol. 2002 Jul;118(1):58-66
references.pmid: 12100128
references.citation: J Clin Oncol. 2009 May 10;27(14):2339-55
references.pmid: 19364955
references.citation: Bone Marrow Transplant. 2005 Jul;36(2):171-6
references.pmid: 15937508
references.citation: Pediatr Blood Cancer. 2008 Jan;50(1):1-8
references.pmid: 17668859
references.citation: Pediatr Blood Cancer. 2008 May;50(5):1018-25
references.pmid: 17849473
references.citation: JAMA. 2007 Jun 27;297(24):2705-15
references.pmid: 17595271
references.citation: Br J Haematol. 2002 Jul;118(1):23-43
references.pmid: 12100126
references.citation: Bone Marrow Transplant. 2008 Jan;41(2):223-7
references.pmid: 17922039