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 |
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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. |
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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.</description><identifier>ISSN: 0268-3369</identifier><identifier>EISSN: 1476-5365</identifier><identifier>DOI: 10.1038/bmt.2013.64</identifier><identifier>PMID: 23665822</identifier><identifier>CODEN: BMTRE9</identifier><language>eng</language><publisher>London: Nature Publishing Group UK</publisher><subject>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</subject><ispartof>Bone marrow transplantation (Basingstoke), 2013-10, Vol.48 (10), p.1291-1295</ispartof><rights>Macmillan Publishers Limited 2013</rights><rights>2014 INIST-CNRS</rights><rights>COPYRIGHT 2013 Nature Publishing Group</rights><rights>Copyright Nature Publishing Group Oct 2013</rights><rights>Macmillan Publishers Limited 2013.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c543t-e62f0a1a90e60ae208e0be1df8f51fe6b7e6e75df90a8389b4550209e2070a783</citedby><cites>FETCH-LOGICAL-c543t-e62f0a1a90e60ae208e0be1df8f51fe6b7e6e75df90a8389b4550209e2070a783</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1038/bmt.2013.64$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1038/bmt.2013.64$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=27801106$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23665822$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Schechter, T</creatorcontrib><creatorcontrib>Pole, J D</creatorcontrib><creatorcontrib>Darmawikarta, D</creatorcontrib><creatorcontrib>Doyle, J</creatorcontrib><creatorcontrib>Ali, M</creatorcontrib><creatorcontrib>Egeler, M</creatorcontrib><creatorcontrib>Gassas, A</creatorcontrib><creatorcontrib>Irwin, M S</creatorcontrib><creatorcontrib>Greenberg, M</creatorcontrib><creatorcontrib>Nathan, P C</creatorcontrib><title>Late mortality after hematopoietic SCT for a childhood malignancy</title><title>Bone marrow transplantation (Basingstoke)</title><addtitle>Bone Marrow Transplant</addtitle><addtitle>Bone Marrow Transplant</addtitle><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.</description><subject>631/250/1904</subject><subject>692/699/67/2332</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Autografts</subject><subject>Biological and medical sciences</subject><subject>Bone marrow</subject><subject>Bone marrow, stem cells transplantation. Graft versus host reaction</subject><subject>Cell Biology</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Childhood</subject><subject>Children</subject><subject>Cohort Studies</subject><subject>Death</subject><subject>Diseases</subject><subject>Graft-versus-host reaction</subject><subject>Health risks</subject><subject>Hematologic Neoplasms - mortality</subject><subject>Hematologic Neoplasms - surgery</subject><subject>Hematology</subject><subject>Hematopoietic Stem Cell Transplantation - adverse effects</subject><subject>Hematopoietic Stem Cell Transplantation - mortality</subject><subject>Hematopoietic stem cells</subject><subject>Humans</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>Internal Medicine</subject><subject>Malignancy</subject><subject>Medical sciences</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Morbidity</subject><subject>Mortality</subject><subject>Ontario - epidemiology</subject><subject>original-article</subject><subject>Pediatrics</subject><subject>Public Health</subject><subject>Stem cell transplantation</subject><subject>Stem Cells</subject><subject>Survival Analysis</subject><subject>Survivors</subject><subject>Transfusions. 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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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