title: The Impact of Donor Type on Long-Term Health Status and Quality of Life after Allogeneic Hematopoietic Stem Cell Transplantation for Childhood Acute Leukemia: A Leucémie de l'Enfant et de L'Adolescent Study.
abstract: We compared the long-term impact of donor type (sibling donor [SD] versus matched unrelated donor [MUD] or umbilical cord blood [UCB]) on late side effects and quality of life (QoL) in childhood acute leukemia survivors treated with hematopoietic stem cell transplantation. We included 314 patients who underwent transplantation from 1997 to 2012 and were enrolled in the multicenter French Leucémie de l'Enfant et de L'Adolescent ("Leukemia in Children and Adolescents") cohort. More than one-third of the patients were adults at last visit; mean follow-up duration was 6.2 years. At least 1 late effect was observed in 284 of 314 patients (90.4%). The average number of adverse late effects was 2.1 ± .1, 2.4 ± .2, and 2.4 ± .2 after SD, MUD, and UCB transplantation, respectively. In a multivariate analysis, considering the SD group as the reference, we did not detect an impact of donor type for most sequelae, with the exception of increased risk of major growth failure after MUD transplantation (odds ratio [OR], 2.42) and elevated risk of osteonecrosis after UCB transplantation (OR, 4.15). The adults and children's parents reported comparable QoL among the 3 groups. Adult patient QoL scores were lower than age- and sex-matched French reference scores for almost all dimensions. We conclude that although these patients are heavily burdened by long-term complications, donor type had a very limited impact on their long-term health status and QoL.
authors: Department of Pediatric Hematology and Oncology, Timone Enfants Hospital and Aix-Marseille University, Marseille, France. Electronic address: sandrine.visentin@ap-hm.fr.
authors: Sandrine
authors: S
authors: Visentin
authors: Research Unit EA 3279 and Department of Public Health, Aix-Marseille University and Timone Hospital Marseille, France.
authors: Pascal
authors: P
authors: Auquier
authors: Department of Pediatric Hematology and Oncology, University Hospital of Lyon, France.
authors: Yves
authors: Y
authors: Bertrand
authors: Pediatric Hematology Department, Robert Debré Hospital, Paris, France.
authors: André
authors: A
authors: Baruchel
authors: Pediatric Hematology Department, Trousseau Hospital, Paris, France.
authors: Marie-Dominique
authors: MD
authors: Tabone
authors: Department of Pediatric Onco-Haematology, Hôpital d'Enfants de Brabois, Vandoeuvre Les Nancy, France.
authors: Cécile
authors: C
authors: Pochon
authors: Department of Pediatric Hematology and Oncology, University Hospital of Bordeaux, France.
authors: Charlotte
authors: C
authors: Jubert
authors: Pediatric Hematology and Oncology Department, University Hospital L'Archet, Nice, France.
authors: Maryline
authors: M
authors: Poirée
authors: Department of Pediatric Hematology and Oncology, University Hospital of Rennes, France.
authors: Virginie
authors: V
authors: Gandemer
authors: Pediatric Hematology and Oncology Department, University Hospital, Montpellier, France.
authors: Anne
authors: A
authors: Sirvent
authors: Department of Pediatric Hematology and Oncology, University Hospital of Rennes, France.
authors: Jacinthe
authors: J
authors: Bonneau
authors: Department of Pediatric Hematology-oncology, University Hospital, Strasbourg, France.
authors: Catherine
authors: C
authors: Paillard
authors: Department of Pediatric Hematology-Oncology, University Hospital of Grenoble, France.
authors: Claire
authors: C
authors: Freycon
authors: Department of Pediatric Hematology and Oncology, CIC Inserm 501, University Hospital of Clermont-Ferrand, France.
authors: Justyna
authors: J
authors: Kanold
authors: Research Unit EA 3279 and Department of Public Health, Aix-Marseille University and Timone Hospital Marseille, France.
authors: Virginie
authors: V
authors: Villes
authors: Research Unit EA 3279 and Department of Public Health, Aix-Marseille University and Timone Hospital Marseille, France.
authors: Julie
authors: J
authors: Berbis
authors: Department of Pediatric Hematology and Oncology, Timone Enfants Hospital and Aix-Marseille University, Marseille, France; Research Unit EA 3279 and Department of Public Health, Aix-Marseille University and Timone Hospital Marseille, France.
authors: Claire
authors: C
authors: Oudin
authors: Department of Pediatric Hematology and Oncology, Timone Enfants Hospital and Aix-Marseille University, Marseille, France.
authors: Claire
authors: C
authors: Galambrun
authors: Pediatric Hematology and Oncology Department, University Hospital of Angers, Angers, France.
authors: Isabelle
authors: I
authors: Pellier
authors: Department of Pediatric Onco-Hematology, CHU-Hospital Purpan, Toulouse, France.
authors: Geneviève
authors: G
authors: Plat
authors: Department of Pediatric Hematology and Oncology, Timone Enfants Hospital and Aix-Marseille University, Marseille, France.
authors: Hervé
authors: H
authors: Chambost
authors: Pediatric Hematology Department, Trousseau Hospital, Paris, France.
authors: Guy
authors: G
authors: Leverger
authors: Pediatric Hematology Department, Robert Debré Hospital, Paris, France.
authors: Jean-Hugues
authors: JH
authors: Dalle
authors: Department of Pediatric Hematology and Oncology, Timone Enfants Hospital and Aix-Marseille University, Marseille, France; Research Unit EA 3279 and Department of Public Health, Aix-Marseille University and Timone Hospital Marseille, France.
authors: Gérard
authors: G
authors: Michel
mesh_terms: D002648:Child; D002675:Child, Preschool; D036101:Cord Blood Stem Cell Transplantation / Q000009:adverse effects; D005260:Female; D006304:Health Status; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods* / Q000523:psychology; D006801:Humans; D007223:Infant; D008297:Male; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000523:psychology / Q000628:therapy*; D011788:Quality of Life; D014019:Tissue Donors; D061349:Unrelated Donors
keywords: Childhood leukemia; Cord blood transplantation; Hematopoietic stem cell transplantation; Late effects; Quality of life