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. 2013 Jul;19(7):1073-80.
doi: 10.1016/j.bbmt.2013.04.002. Epub 2013 Apr 10.

Burden of morbidity in 10+ year survivors of hematopoietic cell transplantation: report from the bone marrow transplantation survivor study

Can-Lan Sun  1 , John H Kersey, Liton Francisco, Saro H Armenian, K Scott Baker, Daniel J Weisdorf, Stephen J Forman, Smita Bhatia
Affiliations

Burden of morbidity in 10+ year survivors of hematopoietic cell transplantation: report from the bone marrow transplantation survivor study

Can-Lan Sun et al. Biol Blood Marrow Transplant. 2013 Jul.

Abstract

Long-term morbidity after hematopoietic cell transplantation (HCT) is unknown. The risk of physical and psychological health in 324 patients who had survived 10 or more years after HCT and a sibling comparison group (n = 309) was evaluated. Using the Common Terminology Criteria for Adverse Events, the 15-year cumulative incidence of severe/life-threatening/fatal conditions was 41% (95% confidence interval, 34% to 48%). HCT survivors were 5.7 times as likely to develop a severe/life-threatening condition (P < .001) and 2.7 times as likely to report somatic distress (P < .001) compared with siblings. Compared with allogeneic HCT recipients with no chronic graft-versus-host disease (GVHD), those with active chronic GVHD were at a 1.8-fold higher risk of severe/life-threatening health conditions (P = .006) and a 4.5-fold higher risk of somatic distress (P = .04); allogeneic HCT recipients with resolved chronic GVHD were not at increased risk of morbidity compared with those with no chronic GVHD. Only 27% of the HCT survivors returned to the transplantation center for their cancer-related care. The burden of long-term physical and emotional morbidity borne by survivors remains substantial, even beyond 10 years after HCT; however, specialized health care is underused. Patients, families, and healthcare providers need to be made aware of the high burden, so they can plan for post-HCT care, even many years after HCT.

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Conflict of interest statement

None of the authors have any conflict to declare.

Figures

Figure 1
Figure 1
Cumulative incidence of chronic health conditions among 10+ year survivors
Figure 2
Figure 2
Cumulative incidence of chronic health conditions among 10+ year survivors: A) Grade 1-5 by stem cell donor source; B) Grade 3-5 by stem cell donor source
Figure 3
Figure 3
Cumulative incidence of chronic health conditions among 10+ year allogeneic HCT survivors: A) Grade 1-5 by chronic GvHD status; B) Grade 3-5 by chronic GvHD status
See this image and copyright information in PMC

References

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