Nonmalignant late effects and compromised functional status in survivors of hematopoietic cell transplantation

Nandita D Khera, Barry Storer, Mary E D Flowers, Paul A. Carpenter, Yoshihiro Inamoto, Brenda M. Sandmaier, Paul J. Martin, Stephanie J. Lee

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56 Scopus citations

Abstract

Purpose: Our objective was to describe the incidence of nonmalignant late complications and their association with health and functional status in a recent cohort of hematopoietic cell transplantation (HCT) survivors. Patients and Methods: We determined the incidence of 14 nonmalignant late effects in adults who underwent transplantation from January 2004 through June 2009 at Fred Hutchinson Cancer Research Center who survived at least 1 year after HCT. Data were derived from review of medical records and annual self-reported questionnaires. Results: The 1,087 survivors in the study had a median age at HCT of 53 years (range, 21 to 78 years) and were followed for a median of 37 months (range, 12 to 77 months) after HCT. The prevalence of pre-existing conditions ranged from 0% to 9.8%. The cumulative incidence of any nonmalignant late effect at 5 years after HCT was 44.8% among autologous and 79% among allogeneic recipients; 2.5% of autologous and 25.5% of allogeneic recipients had three or more late effects. Survivors with three or more late effects had lower physical functioning and Karnofsky score, lower likelihood of full-time work or study, and a higher likelihood of having limitations in usual activities. Predictors of at least one late effect were age ≥ 50 years, female sex, and unrelated donor, but not the intensity of the conditioning regimen. Conclusion: The burden of nonmalignant late effects after HCT is high, even with modern treatments and relatively short follow-up. These late effects are associated with poor health and functional status, underscoring the need for close follow-up of this group and additional research to address these complications.

Original languageEnglish (US)
Pages (from-to)71-77
Number of pages7
JournalJournal of Clinical Oncology
Volume30
Issue number1
DOIs
StatePublished - Jan 1 2012
Externally publishedYes

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ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Khera, N. D., Storer, B., Flowers, M. E. D., Carpenter, P. A., Inamoto, Y., Sandmaier, B. M., Martin, P. J., & Lee, S. J. (2012). Nonmalignant late effects and compromised functional status in survivors of hematopoietic cell transplantation. Journal of Clinical Oncology, 30(1), 71-77. https://doi.org/10.1200/JCO.2011.38.4594