scholarly journals High Rates of Genital Tract Dysplasia in Long-Term Survivors of Allogeneic Stem Cell Transplantation and Associated Risk Factors

2012 ◽  
Vol 18 (2) ◽  
pp. S282
Author(s):  
D.L. Shanis ◽  
P. Pophali ◽  
E. Koklanaris ◽  
B.N. Savani ◽  
M. Battiwalla ◽  
...  
Keyword(s):  
Risk Factors ◽  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Allogeneic Stem Cell Transplantation ◽  
Genital Tract ◽  
Associated Risk Factors ◽  
Long Term Survivors

Delayed Platelet Recovery After Allogeneic Peripheral Blood, Marrow and Umbilical Cord Stem Cell Transplantation: Risk Factors and Clinical Outcomes.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 867-867
Author(s):  
Pablo A Ramirez ◽  
Claudio Brunstein ◽  
Brian Miller ◽  
Todd E. DeFor ◽  
Daniel J. Weisdorf
Keyword(s):  
Risk Factors ◽  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Allogeneic Stem Cell Transplantation ◽  
Peripheral Blood ◽  
Myeloablative Conditioning ◽  
Platelet Recovery ◽  
Donor Type ◽  
Associated Risk Factors

Abstract Abstract 867 Introduction: Several reports have shown that despite prompt neutrophil engraftment after allogeneic stem cell transplantation, there can be delayed platelet recovery, especially in umbilical cord blood (UCB) stem cell transplant recipients. This dichotomy in platelets and neutrophils engraftment is poorly explained. In addition, the risk factors and complications associated with delayed platelet recovery are not clearly identified. Methods: We conducted a retrospective analysis to characterize the frequency of delayed platelet recovery and its associated risk factors and related complications. All allografts at the University of Minnesota between 2000 and 2005 were included. Results: 875 patients with hematologic malignancies or benign disorders were included. Myeloablative conditioning was used in 576 (66%) patients and non-myeloablative conditioning in 299 (34%) patients. 343 (39%) patients received related donor and 532 (61%) unrelated grafts. The source of the graft was bone marrow in 226 (26%) patients, peripheral blood in 255 (29%) patients and UCB in 394 (45%) patients. 150 (17%) patients were excluded due to early death (n=87, 10%), graft failure (n=62, 7%) and second transplant without engraftment (n=1). The 60 day cumulative incidence of platelet recovery by donor type was UCB single cord 39% (n=180, CI 31-47%), UCB double cord 40% (n=206, CI 32-48%), URD mismatched 57% (n=28, CI 39-75%), URD matched 56% (n=117, 48-64%) and sibling 74% (n=319, 65-85%). Overall, 232 (32%) had delayed platelet recovery (platelets<50K by day 60) and 475 (67%) had successful recovery (platelets>50K by day 60). Cox regression analysis showed that variables significantly associated with delayed platelet recovery were donor type (UCB RR 0.3 [CI 0.2-0.35], p<0.01 vs sibling RR 1.0), ABO match (major mismatch RR 0.8 [CI 0.6-1.0], p<0.01 vs matched RR 1.0), CMV status (positive RR 0.8 [CI 0.6-1.0], p=0.04 vs negative RR 1.0) and the vs negative RR 1.0). Transplant related mortality (TRM) at 12 months was also higher in patients with delayed platelet recovery compared to patients with successful platelet recovery (30% vs 11%) (p<0.01). Risk factors for TRM by proportional hazard regression were delayed platelet engraftment (RR 3.9 [2.6-6.0], p=<0.01 vs early RR 1.0), HLA mismatched unrelated donor (RR 3.7 [CI 2.5-7.1], p=0.01 vs sibling RR 1.0), severe aGVHD (RR 1.8 [CI 1.2-2.8], p=0.02 vs no severe RR 1.0) and age > 35 (RR 1.6 [CI 1.0-2.5], p=0.03 vs age < 35 RR 1.0). Successful platelet recovery was associated with a 77% 1 year survival versus only 59% in patients with delayed platelet recovery (p<0.01). Conclusions: These results suggest that delayed platelet recovery and poor graft function are common complications of allogeneic stem cell transplantation, especially after UCB grafts. Further study is needed to determine if modification of these associated risk factors will reduce the risks of severe complications and improve survival. Disclosures: No relevant conflicts of interest to declare.

Pulmonary function in very long-term survivors after allogeneic stem cell transplantation (aSCT)

2018 ◽  
Author(s):  
Ole Henrik Myrdal ◽  
Phoi Phoi Diep ◽  
Ellen Ruud ◽  
Johny Kongerud ◽  
Liv Ingunn Bjoner Sikkeland ◽  
...  
Keyword(s):  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Pulmonary Function ◽  
Cell Transplantation ◽  
Allogeneic Stem Cell Transplantation ◽  
Long Term Survivors

scholarly journals Late Mortality and Causes of Death among Long-Term Survivors after Allogeneic Stem Cell Transplantation

2016 ◽  
Vol 22 (9) ◽  
pp. 1702-1709 ◽  
Author(s):  
Yoshiko Atsuta ◽  
Akihiro Hirakawa ◽  
Hideki Nakasone ◽  
Saiko Kurosawa ◽  
Kumi Oshima ◽  
...  
Keyword(s):  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Allogeneic Stem Cell Transplantation ◽  
Causes Of Death ◽  
Late Mortality ◽  
Long Term Survivors

scholarly journals Predictors of impaired bone health in long-term survivors after allogeneic stem cell transplantation

2019 ◽  
Vol 54 (10) ◽  
pp. 1651-1661 ◽  
Author(s):  
Annic Baumgartner ◽  
Michèle Moesch ◽  
Melanie Zumsteg ◽  
Tristan Struja ◽  
Selina Bernet ◽  
...  
Keyword(s):  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Allogeneic Stem Cell Transplantation ◽  
Bone Health ◽  
Long Term Survivors

Factors Affecting Quality of Life During and After Stem Cell Transplantation in Long Term Survivors – Comparison of Autologous and Allogeneic Stem Cell Transplantation

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 590-590
Author(s):  
Katerina Benesova ◽  
Marie Trnkova ◽  
Miriam Lanska ◽  
Veronika Valkova ◽  
Katerina Steinerova ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Allogeneic Stem Cell Transplantation ◽  
Well Being ◽  
Myelogenous Leukemia ◽  
Long Term Survivors

Abstract Abstract 590 Background: Myeloblative conditioning (MAC) or reduced intensity conditioning (RIC) followed by autologous or allogeneic stem cell transplantation (ASCT or AlloSCT) is established and lifesaving treatment in selected indications. The quality of life (QoL) is then very important issue for long term surviving patients. The majority of data is often based on single center evaluation with limited number of patients. Therefore we have started the cross-sectional QoL project and this analysis is based on data collected from eight transplant centers. Methods: Altogether data from 1399 patients are included in the study. The FACT-G questionnaire (Q) was used for this analysis. The questionnaire consists of four parts - physical well-being (PWB), social/family well-being (SWB), emotional well-being (EWB), functional well-being (FWB). The patients completed the Q before the transplantation (at the time of indication or at the time of admission to SCT) n=304, after ASCT n=662 and after AlloSCT n=433. Patients were divided into 7 groups – before SCT, day +100, up to 1y, 1–2y, 2–3y, 3–5y and more than 5y. The clinical characteristics were obtained from national transplant registry; the data was cleaned and updated. Wilcoxon and Kruskall-Wallis tests were used for statistical analysis. Patient′s characteristic: The ASCT and AlloSCT groups (grp.) consist of 869 and 530 pts resp. including 207 pts before ASCT and 97 before AlloSCT. There were 52.8% and 55.7% men in ASCT and AlloSCT grp. resp. The median age in ASCT and AlloSCT grp. resp. was: 55.2 and 43.2y resp., the median follow-up 4.4 and 4.5y resp. The most frequent diagnosis of ASCT group were: Non-Hodgkin′s lymphoma (NHL) 46.1%, multiple myeloma (MM) 36.6%, Hodgkin′s lymphoma (HL) 8.5%. In AlloSCT: acute myelogenous leukemia 29.4%, acute lymphoblastic leukemia 15.7%, chronic myeloid leukemia 11.5% and myelodysplastic syndrome 10.0%. Disease progression/relapse was observed in 148 ASCT (22.4%) and 61 AlloSCT (14.1%) pts. In AlloSCT group MAC was used in 33% pts and matched unrelated donor (MUD) in 59.8% pts., aGVHD gr I-II was observed in 40.3% and gr III-IV 4.2% pts, cGVHD in 37.9% pts. Results: Significant differences in overall QoL before, during and after the AlloSCT (p<0.001) and ASCT (p=0.01) were observed. The QoL was improved from 1y after ASCT as well as from 2y after Allo-SCT. It was due mainly to the PWB and FWB improvement in both SCT groups, SWB and EWB remained unchanged. Long term survivors reported better QoL vs pts before transplant both in the alloSCT gr. (89 vs 80.7 points) as well as in ASCT gr.(82 vs 73.1). Interestingly, significantly better QoL in AlloSCT vs ASCT gr. was reported in all time points except day +100 and 2y. At the time of indication it was 80.7 vs 73.1 (p=0.035) and the most significant difference was among long-term survivors 89.0 vs 82.0 (p<0.001). The overall QoL was not affected by gender, women only reported better SWB in AlloSCT and ASCT grp. and men reported better EWB in ASCT gr. The age had significant impact on overall QoL in ASCT (p=0.005) and AlloSCT (p=0.006) but only due to difference in PWB and FWB resp., which was more profound in AlloSCT (p<0.001). The diagnosis had no impact on QoL in AlloSCT grp. but the MM pts have significantly lower QoL compared to NHL and HL pts. resp. (73 vs 80 vs 82 resp. p<0.001) in ASCT group. There was no significant impact of MAC or RIC on the QoL, patients with MUD has lower QoL compared to sibling donor (84.8 vs 88, p<0.05). Relapse after transplantation was associated with worse QoL, after ASCT 74 vs 81 (p=0.02) and after AlloSCT 81.5 vs 87.5 (borderline significance p =0.065). The long term survivor′s QoL was not affected by aGVHD in contrast to the cGVHD which significantly affects QoL (p<0.001) due to lower PWB (p<0.001) and FWB (p<0.001). Conclusion: We herein demostrate on large cohorts of pts that long term survivors have significantly better QoL compared to QoL in the time of indication of the transplantation and the improvement starts from 1y after ASCT and from 2y after AlloSCT. AlloSCT survivors report better QoL compared to the ASCT survivors. The most important factors affected QoL are age, cGVHD (AlloSCT) and diagnosis (ASCT), the borderline factors are relapse after SCT and type of donor (AlloSCT). Disclosures: No relevant conflicts of interest to declare.

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