Naslov
Late complications (LC) and quality of life (QOL) after allogeneic stem cell transplantation (allo-SCT)

Autori
Perić, Zinaida ; Duraković, Nadira ; Grković, Lana ; Serventi-Seiwerth, Ranka ; Ostojić, Alen ; Vrhovac, Radovan ; Nemet, Damir

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Izvornik
41st Annual Meeting of the European Society for Blood and Marrow Transplantation : abstracts ; u: Bone marrow transplantation 50 (2015) (S1) S1-S644 ; Bone marrow transplantation S312-S499 / Lazarus, Hillard M. ; Mohty, Mohamad - London : Delhi : Nature publishing group, 2015, S435-S436

Skup
Annual Meeting of the European Society for Blood and Marrow Transplantation (41 ; 2015)

Mjesto i datum
Istanbul, Turska, 22.03.2015. - 25.03.2015

Vrsta sudjelovanja
Poster

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
Hematopoietic Stem Cell Transplantation ; GvHD ; Quality of Life

Sažetak
Introduction: While the features of early complications of allo-SCT are well known, data is still sparse in the setting of LC and especially long term QOL after allo-SCT. Materials (or patients) and methods: This report analyzed the features of LC and QOL after day þ100 in 39 consecutive patients who underwent allo-SCT in our institution and survived for a minimum of 2 years after transplantation. QOL was assessed in a cross- sectional study by the use of EORTC QLQ-C30 and SF-36 questionnaires. Results: The median age of 19 female and 20 male recipients was 44 (range, 18-58) years. In all, 12 patients (31%) had a lymphoid malignancy, while 27 patients (69%) were diagnosed with myeloid malignancies. In total, 27 patients (69%) received peripheral blood stem cells, while 12 patients (31%) received unmanipulated bone marrow. Twenty-five grafts (64%) were obtained from HLA identical siblings, 13 (33%) from HLAmatched unrelated donors and 1 (3%) from a haploidentical donor. Twenty patients (51%) received a myeloablative conditioning and 19 patients received fludarabine, busulfan and ATG-based reduced- intensity conditioning regimen (49%). With a median follow-up of 945 days (range, 725-1451), chronic GVHD (cGVHD) was the most prevalent late complication with a cumulative incidence of 44% (95%CI, 27-59) at 2 years. Late infections, mostly viral, also had a cumulative incidence of 44% (95% CI 28-60). The cumulative incidence od organ-specific LC was 58% (95% CI 24-82%). Pulmonary complications were often related to cGVHD for a cumulative incidence of 22% (95%CI, 6-44). The cumulative incidence of cardiovascular complications was 5% (95%CI, 1- 15) and of renal impairment 9% (95%CI, 1-28). Endocrine disorders had a cumulative incidence of 18% (95%CI, 7-34) involving thyroid dysfunction in 5% (95% CI 1-15). A secondary malignancy occured in one patient as metastatic pancreatic adenocarcinoma and led to the patient’s death. In the univariate analysis, age of patients, type of conditioning, donor or source of the cells did not influence the incidence of LC. However, patients with grade II-IV acute GVHD had significantly (P¼0.02) higher cumulative incidence of organ-related LC (67%, 95%CI 28-88) compared to patients with grade 0-I acute GVHD (23%, 95% CI 8-43). In this series, 33 patients (85%) accepted to participate in the QOL survey. Among these, 15 patients (45%) had developed cGVHD after allo- SCT. Overall, patients had good global quality of life with a general health score of 50 (SD 18) in the SF-36 and mean global QOL group score of 62 (SD 22) in the QLQ-C30 questionnaire. Compared to the group without cGVHD, patients with cGVHD had significantly lower QOL in terms of emotional well-being and social functioning in the SF-36 questionnaire. Similarly, in the EORTC QLQ-C30, patients with cGVHD had significantly lower QOL in terms of emotional, cognitive and social functioning and reported significantly more financial disturbancies (Po0.05 for all comparisons). Interestingly, there were no significant diferences in the terms of physical functioning and symptom scales between these two groups of patients. Conclusion: In summary, patients who have clinically severe acute GVHD after allo- SCT have a higher probability of late organ- related complications. Among these complications, chronic GVHD remains to be a most prevalent problem that affects QOL, requiring long-term appropriate psychological support for patients. Disclosure of Interest: None declared.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

Napomena
Doi:10.1038/bmt.2015.30

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