Late mortality in survivors of autologous hematopoietic-cell transplantation: Report from the Bone Marrow Transplant Survivor Study

Smita Bhatia, Leslie L. Robison, Liton Francisco, Andrea Carter, Yan Liu, Marcia Grant, K. Scott Baker, Henry Fung, James G. Gurney, Philip B. McGlave, Auayporn Nademanee, Norma K.C. Ramsay, Anthony Stein, Daniel J. Weisdorf, Stephen J. Forman

Research output: Contribution to journalArticlepeer-review

207 Scopus citations

Abstract

We assessed late mortality in 854 individuals who had survived 2 or more years after autologous hematopoietic cell transplantation (HCT) for hematologic malignancies. Median age at HCT was 36.5 years, and median length of follow-up was 7.6 years. Overall survival was 68.8% ± 1.8% at 10 years, and the cohort was at a 13-fold increased risk for late death (standardized mortality ratio [SMR] = 13.0) when compared with the general population. Mortality rates approached those of the general population after 10 years among patients at standard risk for relapse at HCT (SMR = 1.1) and in patients undergoing transplantation for acute myeloid leukemia (AML; SMR = 0.9). Relapse of primary disease (56%) and subsequent malignancies (25%) were leading causes of late death. Relapse-related mortality was increased among patients with Hodgkin disease (HD; relative risk [RR] = 3.6), non-Hodgkin lymphoma (NHL; RR = 2.1), and acute lymphoblastic leukemia (ALL; RR = 6.5). Total body irradiation (RR = 0.6) provided a protective effect. Non-relapse-related mortality was increased after carmustine (RR = 2.3) and with use of peripheral blood stem cells (RR = 2.4). Survivors were more likely to report difficulty in holding jobs (RR = 9.4) and in obtaining health (RR = 7.7) or life insurance (RR = 8.4) when compared with siblings. Although mortality rates approach that of the general population after 10 years in certain subgroups, long-term survivors of autologous HCT continue to face challenges affecting their health and well-being.

Original languageEnglish (US)
Pages (from-to)4215-4222
Number of pages8
JournalBlood
Volume105
Issue number11
DOIs
StatePublished - Jun 1 2005

Fingerprint

Dive into the research topics of 'Late mortality in survivors of autologous hematopoietic-cell transplantation: Report from the Bone Marrow Transplant Survivor Study'. Together they form a unique fingerprint.

Cite this