Yazarlar : Bieri S, Roosnek E, Ozsahin H, Huguet S, Ansari M, Trombetti A, Helg C, Chapuis B, Miralbell R, Passweg J, Chalandon Y.

Yayın : Eur J Haematol.

Yayın Yılı : 2011

Pubmed Linki : http://www.ncbi.nlm.nih.gov/pubmed/21535161

Konu : Radyasyon Onkolojisi

Literatür İçeriği :

Objectives:  The aim of this retrospective study was to assess the incidence of late complications occurring ≥2 years after allogeneic hematopoietic stem cell transplantation (HSCT) for malignant diseases using a T-cell depletion strategy. Methods:  Between 1984 and 2004, 142 patients were eligible for the study. Total body irradiation (TBI) was done in 85% of the patients and T-cell depletion in 84%. Results:  Non-relapse mortality (NRM) was 3% (95% CI 0-11%) at 10 years and serious late events affected a substantial number of patients. The cumulative incidence (CI) of chronic graft-versus-host disease (cGvHD) was 30% (95% CI 23-40%) and that of infectious complications was 17% (95% CI 11-23%). Multivariate analysis showed a higher risk for late complications in patients with cGvHD (p=0.011 HR 1.9, 95% CI 1.2-3.2) and in patients receiving methylprednisolone during conditioning (p=0.019 1 HR 1.9, 95% CI 1.1-3.3), patients with cGvHD also having a higher risk for NRM (HR 13.2, 95% CI 1.2-143, p=0.03), as well as those receiving steroids for >3 months (HR 40.3 95% CI 2.3-718), p=0.02), and those receiving antithymocyte globulin, HR 9.6 (95% CI 0.8-68), p=0.024. Conclusions:  A significant proportion of long-term survivors of HSCT had late complications. cGvHD remained an important risk factor for late complications despite T-cell depletion resulting in immunosuppression and infectious complications.

© 2011 John Wiley & Sons A/S.

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