1. Burden of Morbidity in 10+ Year Survivors of Hematopoietic Cell Transplantation: Report from the Bone Marrow Transplantation Survivor Study.
- Author
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Sun, Can-Lan, Kersey, John H., Francisco, Liton, Armenian, Saro H., Baker, K. Scott, Weisdorf, Daniel J., Forman, Stephen J., and Bhatia, Smita
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HEMATOPOIETIC stem cell transplantation , *GRAFT versus host disease , *CANCER-related mortality , *MEDICAL care , *COMPARATIVE studies , *BONE marrow transplantation , *ADVERSE health care events , *PSYCHOPHYSIOLOGY - Abstract
Abstract: Long-term morbidity after hematopoietic cell transplantation (HCT) is unknown. The risk of physical and psychological health in 324 patients who had survived 10 or more years after HCT and a sibling comparison group (n = 309) was evaluated. Using the Common Terminology Criteria for Adverse Events, the 15-year cumulative incidence of severe/life-threatening/fatal conditions was 41% (95% confidence interval, 34% to 48%). HCT survivors were 5.7 times as likely to develop a severe/life-threatening condition (P < .001) and 2.7 times as likely to report somatic distress (P < .001) compared with siblings. Compared with allogeneic HCT recipients with no chronic graft-versus-host disease (GVHD), those with active chronic GVHD were at a 1.8-fold higher risk of severe/life-threatening health conditions (P = .006) and a 4.5-fold higher risk of somatic distress (P = .04); allogeneic HCT recipients with resolved chronic GVHD were not at increased risk of morbidity compared with those with no chronic GVHD. Only 27% of the HCT survivors returned to the transplantation center for their cancer-related care. The burden of long-term physical and emotional morbidity borne by survivors remains substantial, even beyond 10 years after HCT; however, specialized health care is underused. Patients, families, and healthcare providers need to be made aware of the high burden, so they can plan for post-HCT care, even many years after HCT. [Copyright &y& Elsevier]
- Published
- 2013
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