Naslov
Long-term complications and quality of life after reducedintensity conditioning allogeneic stem cell transplantation

Autori
Clavert, Aline ; Peric, Zinaida ; Cahu, Xavier ; Chevallier, Patrice ; Brissot, Eolia ; Malard, Florent ; Guillaume, Thierry ; Delaunay, Jacques ; Ayari, Sameh ; Dubruille, Vivianne ; Le Gouill, Steven ; Mahe, Beatrice ; Gastinne, Thomas ; Blin, Nicolas ; Harrousseau, Jean-Luc ; Moreau, Philippe ; Milpied, Noel ; Mohty, Mohamad

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

Izvornik
Bone Marrow Transplantation 47 / - , 2012

Skup
38th Annual Meeting of the European Group for Blood and Marrow Transplantation

Mjesto i datum
Ženeva, Švicarska, 01.04.2012. - 04.04.2012

Vrsta sudjelovanja
Poster

Vrsta recenzije
Nije recenziran

Ključne riječi
QOL; RIC; late complications

Sažetak
Background: RIC allo-SCT is increasingly used in elderly or frail patients (pts) not eligible for myeloablative conditioning. While the natural history of LTC and QOL are rather well described in the myeloablative allo-SCT setting, data is still sparse in the RIC setting. This single centre survey analyzed the outcome and features of LTC and QOL in 110 RIC allo-SCT pts who survived for a minimum of 2 years (y) after allo-SCT. QOL was assessed in a cross-sectional study using the EORTC QLQC30 questionnaire and the FACT-BMT questionnaire. Results: The K-M estimate of overall survival (OS) was 93% (95%CI, 88-99%) and 81% (95%CI, 71-94%) at 5 and 10 y, respectively. The primary cause of death was relapse found in 4 pts (4%). Six pts (5%) died of non-relapse-related causes as secondary malignancies (n=3), chronic GVHD (cGVHD ; n=2) and infection (n=1). With a median follow-up of 4.6 y (range, 2-12.1), cGVHD was the most prevalent LTC with a cumulative incidence (CInc) of 66% (95%CI, 57-74) at 10 y. In multivariate analysis, a mismatched unrelated donor allo-SCT was the strongest independent risk factor associated with the development of LTC (RR=4.06, 95%CI 1.81-9.10, p=0.002).In this series, 61 pts (55%) responded to the different questionnaires. Overall, in the EORTC QLQ-C30 questionnaire 70% of these pts reported a good to very good QOL, with a mean global QOL group score of 71.7 (SD, 20.8). Compared to the group without cGVHD, pts with cGVHD had signifi cantly lower QOL. Similarly, in the FACT-BMT questionnaire the scores in all subscales indicated good QOL. However, there was statistically signifi cant differences between the two groups in average QOL scores in the physical and functional well-being and BMT subscales, as well as for the FACT-G, FACT-TOI and FACT-BMT total composite scores. Moreover, the QOL survey revealed that 29% of working age-patients could return to full-time work. Finally, 2 childbearing age women (18%) were reported to have had pregnancies. Conclusion: Pts who are alive beyond 2 y after RIC allo-SCT have a high probability of cure with excellent OS and good QOL. However, cGVHD remains an issue requiring long-term appropriate psychological support. Also, the natural history of LTC after RIC appears to be different from that described in the standard myeloablative setting, warranting more research in this fi eld and lifelong surveillance through a close partnership between the transplant center and organ-specifi c specialities

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

POVEZANOST RADA