4.2 Article

Late effects in survivors of Hodgkin and non-hodgkin lymphoma treated with autologous hematopoietic cell transplantation: A report from the bone marrow transplant survivor study

Journal

BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION
Volume 13, Issue 10, Pages 1153-1159

Publisher

ELSEVIER SCIENCE INC
DOI: 10.1016/j.bbmt.2007.06.003

Keywords

autologous hematopoietic cell transplantation; Hodgkin lymphoma; non-Hodgkin lymphoma; late complications

Funding

  1. NCI NIH HHS [K23 CA85503-01, K23 CA085503, R01 CA078938-03, R01 CA078938-04, R01 CA078938-01A2, R01 CA078938, R01 CA078938-02] Funding Source: Medline

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We determined the prevalence of self-reported late-effects in survivors of autologous hematopoictic cell transplantation (HCT) for Hodgkin lymphoma (HL, n = 92) and non-Hodgkin lymphoma (NHL, n = 184) using a 255-item questionnaire and compared them to 319 sibling controls in the Bone Marrow Transplant Survivor Study. Median age at HCT was 39 years (range: 13-69) and median posttransplant follow-up was 6 years (range: 2-17). Median age at survey was 46 years (range: 21-73) for survivors and 44 years (range: 19-79) for siblings. Compared to siblings, HCT survivors reported a significantly higher frequency of cataracts, dry mouth, hypothyroidism, bone impairments (osteoporosis and avascular necrosis), congestive heart failure, exercise-induced shortness of breath, neurosensory impairments, inability to attend work or school, and poor overall health. Compared to those receiving no total-body irradiation (TBI), patients treated with TBI-based conditioning had higher risks of cataracts (odds-ratio [OR] 4.9, 95% confidence interval [CI] 1.5-15.5) and dry mouth (OR 3.4,95% CI 1.1-10.4). Females had a greater likelihood of reporting osteoporosis (OR 8.7,95% CI: 1.8-41.7), congestive heart failure (OR 4.3, 95% CI 1.1-17.2), and abnormal balance, tremor, or weakness (OR 2.4, 95% CI 1.0-5.5). HL and NHL survivors of autologous HCT have a high prevalence of long-term health-related complications and require continued monitoring for late effects of transplantation. (C) 2007 American Society for Blood and Marrow Transplantation.

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