title: Health status, late effects and long-term survivorship of allogeneic bone marrow transplantation: a retrospective study.
abstract: BACKGROUND
  Survival after allogeneic haemopoietic stem cell transplantation (allo-HSCT) has improved because of advancements in allo-HSCT. Allo-HSCT has been performed in Australia since the late 1970s. However, there are few published data about health problems of allo-HSCT survivors in Australia.
  
  
  OBJECTIVE
  Identify health issues in long-term survivors of allo-HSCT in an Australian centre to manage better and prevent long-term complications.
  
  
  METHODS
  The health records of all patients of allo-HSCT in a single centre from January 2000 to December 2007 and survived beyond 2 years were assessed.
  
  
  RESULTS
  Ninety-nine of the 200 allo-HSCT patients survived beyond 2 years, and the median time from allo-HSCT was 74 months. Twenty-eight per cent died at a median of 37 months after allo-HSCT because of relapsed malignancy (12%), stroke (1%), infection (3%), chronic graft versus host disease (9%), secondary malignancy (2%) and unknown cause (1%). Ninety-one per cent reported one or more chronic health conditions. Health issues were chronic graft versus host disease (70%); respiratory (66%), ophthalmic (40%), bone (33%), and renal (26%) problems; and malignancies (14% skin, 3% solid organ). Seventy-nine per cent resumed vocation at full or reduced capacity 2 years after allo-HSCT. Clinicians identified 40% with quality of life (QOL) issues, but survivors' self-reported QOL was comparable with the general Australian population.
  
  
  CONCLUSIONS
  This study shows that allo-HSCT patients are living with high burdens of chronic diseases that warrant lifelong surveillance and engagement with healthcare. Structured, multi-disciplinary care as recommended by published guidelines for allo-HSCT survivors may reduce long-term effects and improve their outcomes.
authors: Department of Haematology and Bone Marrow Transplantation, St Vincent's Hospital, Sydney, New South Wales, Australia.
authors: G
authors: G
authors: Gifford
authors: J
authors: J
authors: Sim
authors: A
authors: A
authors: Horne
authors: D
authors: D
authors: Ma
mesh_terms: D000328:Adult; D001315:Australia / Q000453:epidemiology; D016026:Bone Marrow Transplantation / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data; D003695:Delivery of Health Care / Q000379:methods / Q000458:organization & administration; D005260:Female; D006086:Graft vs Host Disease / Q000209:etiology; D054624:Health Status Disparities; D019337:Hematologic Neoplasms / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology / Q000628:therapy; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012189:Retrospective Studies; D015996:Survival Rate; D017741:Survivors / Q000523:psychology / Q000706:statistics & numerical data; D013995:Time
keywords: allogeneic bone marrow transplantation; health status; late effect; lifelong surveillance; long-term survivorship; quality of life