The Late Effects in Patients Treated with Allogeneic Hematopoietic Stem Cell Transplantation

Česká verzia

Authors: Ľ. Roziaková ^1,2; E. Bojtárová ²; M. Mistrík ²; B. Mladosievičová ¹
Authors place of work: Ústav patologickej fyziológie, LF UK Bratislava, Slovenská republika ¹; Klinika hematológie a transfuziológie, LF UK, SZU a UN Bratislava, Slovenská republika ²
Published in the journal: Klin Onkol 2011; 24(6): 453-459
Category: Original Articles

Summary

Backgrounds:
Allogeneic hematopoietic stem cell transplantation (HSCT) has become a curative treatment option for a variety of malignant and non-malignant hematological disorders. The number of long-term survivors after HSCT is continuously increasing and quality of their life represents a multidisciplinary concern. The aim of this study was to evaluate the prevalence of the late effects in long-term allogeneic HSCT survivors.

Patients and Methods:
The study included 45 patients aged 12–63 years who survived at least two years after allogeneic HSCT for a hematological disorder. Twelve (26.7%) patients received an irradiation-based conditioning regimen. Median follow-up was 6 years (range 2–18 years).

Results:
Toxicity varied from subclinical to life-threatening. The prevalence of at least one late toxic effect was 88.9%. Endocrine and metabolic complications included thyroid abnormalities in 12 (26.7%) patients, bone and joints complications in 13 (28.8%) and metabolic syndrome in 13 (28.8%). Ocular complications were diagnosed in 20 (44.4%), cardiovascular abnormalities in 15 (33.3%), pulmonary dysfunction in 6 (13.3%) and secondary malignancies in 3 (6.67%) survivors. The number of complications per patient increased with time from HSCT. Chronic graft-versus-host disease was the most significant risk factor associated with ocular, pulmonary and osteoarticular complications.

Conclusion:
Late toxicity of allogeneic HSCT in patients surviving for more than 2 years after this procedure may facilitate conduct of longer follow-up studies and an implementation of interventions to prevent late effects among survivors of serious hematological diseases

Key words:
adverse effects – hematopoietic stem cell transplantation – long-term follow up studies

This study was partly funded by the grats of MZ SR 2007/42-UK-18.

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE “uniform requirements” for biomedical papers.

Submitted:
24. 3. 2011

Accepted:
26. 9. 2011

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