Late mortality after hematopoietic SCT for a childhood malignancy

Hematopoietic SCT (HSCT) has been used as a curative therapy for pediatric malignancies. Survivors of HSCT are at risk for disease recurrence, late morbidity and mortality. We assessed late mortality (⩾2 years post-HSCT) in a population-based cohort of children who underwent HSCT for a malignancy. M...

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Veröffentlicht in:Bone marrow transplantation (Basingstoke) 2013-10, Vol.48 (10), p.1291-1295
Hauptverfasser: Schechter, T, Pole, J D, Darmawikarta, D, Doyle, J, Ali, M, Egeler, M, Gassas, A, Irwin, M S, Greenberg, M, Nathan, P C
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container_end_page 1295
container_issue 10
container_start_page 1291
container_title Bone marrow transplantation (Basingstoke)
container_volume 48
creator Schechter, T
Pole, J D
Darmawikarta, D
Doyle, J
Ali, M
Egeler, M
Gassas, A
Irwin, M S
Greenberg, M
Nathan, P C
description Hematopoietic SCT (HSCT) has been used as a curative therapy for pediatric malignancies. Survivors of HSCT are at risk for disease recurrence, late morbidity and mortality. We assessed late mortality (⩾2 years post-HSCT) in a population-based cohort of children who underwent HSCT for a malignancy. Mortality outcomes were determined by linking a clinical transplant database with the Canadian province of Ontario’s pediatric cancer mortality files. Seven hundred and fifty-four children underwent HSCT (371 allogeneic, 383 autologous). Of the 479 (63.5%) who were alive ⩾2 years post HSCT, 98 (20.5%) suffered a late death. Late mortality in the allogeneic HSCT group was 14.9% (median follow-up 10.0 years; range: 2.0–25.6 years), mainly due to relapse of the primary malignancy (64.7%). Chronic GVHD and second malignancies were not major causes of late mortality. A total of 25.5% suffered a late death following autologous HSCT (median follow-up 6.7 years; range: 2.0–22.2 years). Recurrence of the primary malignancy accounted for 87.5% of these deaths. Recurrence of the primary malignancy is the predominant cause of late mortality after HSCT. In contrast to studies of adult patients, non-relapse mortality is less common in children, and death due to chronic GVHD and secondary malignancies is uncommon.
doi_str_mv 10.1038/bmt.2013.64
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Survivors of HSCT are at risk for disease recurrence, late morbidity and mortality. We assessed late mortality (⩾2 years post-HSCT) in a population-based cohort of children who underwent HSCT for a malignancy. Mortality outcomes were determined by linking a clinical transplant database with the Canadian province of Ontario’s pediatric cancer mortality files. Seven hundred and fifty-four children underwent HSCT (371 allogeneic, 383 autologous). Of the 479 (63.5%) who were alive ⩾2 years post HSCT, 98 (20.5%) suffered a late death. Late mortality in the allogeneic HSCT group was 14.9% (median follow-up 10.0 years; range: 2.0–25.6 years), mainly due to relapse of the primary malignancy (64.7%). Chronic GVHD and second malignancies were not major causes of late mortality. A total of 25.5% suffered a late death following autologous HSCT (median follow-up 6.7 years; range: 2.0–22.2 years). Recurrence of the primary malignancy accounted for 87.5% of these deaths. Recurrence of the primary malignancy is the predominant cause of late mortality after HSCT. In contrast to studies of adult patients, non-relapse mortality is less common in children, and death due to chronic GVHD and secondary malignancies is uncommon.</abstract><cop>London</cop><pub>Nature Publishing Group UK</pub><pmid>23665822</pmid><doi>10.1038/bmt.2013.64</doi><tpages>5</tpages></addata></record>
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subjects 631/250/1904
692/699/67/2332
Adolescent
Adult
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Autografts
Biological and medical sciences
Bone marrow
Bone marrow, stem cells transplantation. Graft versus host reaction
Cell Biology
Child
Child, Preschool
Childhood
Children
Cohort Studies
Death
Diseases
Graft-versus-host reaction
Health risks
Hematologic Neoplasms - mortality
Hematologic Neoplasms - surgery
Hematology
Hematopoietic Stem Cell Transplantation - adverse effects
Hematopoietic Stem Cell Transplantation - mortality
Hematopoietic stem cells
Humans
Infant
Infant, Newborn
Internal Medicine
Malignancy
Medical sciences
Medicine
Medicine & Public Health
Morbidity
Mortality
Ontario - epidemiology
original-article
Pediatrics
Public Health
Stem cell transplantation
Stem Cells
Survival Analysis
Survivors
Transfusions. Complications. Transfusion reactions. Cell and gene therapy
Transplantation
Treatment Outcome
Young Adult
title Late mortality after hematopoietic SCT for a childhood malignancy
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