Long-Term Survival and Late Deaths After Allogeneic Hematopoietic Cell Transplantation
Cleveland Clinic · UF Health Shands Hospital · +7 more institutions
Abstract
Median follow-up was 9 years, and 3,788 patients had been observed for 10 or more years. The probability of being alive 10 years after HCT was 85%. The chief risk factors for late death included older age and chronic graft-versus-host disease (GVHD). For patients who underwent transplantation for malignancy, relapse was the most common cause of death. The greatest risk factor for late relapse was advanced disease at transplantation. Principal risk factors for nonrelapse deaths were older age and GVHD. When compared with age, sex, and nationality-matched general population, late deaths remained higher than expected for each disease, with the possible exception of lymphoma, although the relative risk generally receded over time.
The prospect for long-term survival is excellent for 2-year survivors of allogeneic HCT. However, life expectancy remains lower than expected. Performance of HCT earlier in the course of disease, control of GVHD, enhancement of immune reconstitution, less toxic regimens, and prevention and early treatment of late complications are needed.
Citation impact
- FWCI
- 12.43
- Percentile
- 100%
- References
- 34
Authors
11- JRJohn R. WingardCorresponding
Cleveland Clinic, UF Health Shands Hospital, Children's National, Medical College of Wisconsin, University of Florida, Fred Hutch Cancer Center, University of Minnesota Medical Center, Hôpital Saint-Louis, Florida College
- NSNavneet S. Majhail
Cleveland Clinic, UF Health Shands Hospital, Children's National, Medical College of Wisconsin, University of Florida, Fred Hutch Cancer Center, University of Minnesota Medical Center, Hôpital Saint-Louis, Florida College
- RBRuta Brazauskas
Cleveland Clinic, UF Health Shands Hospital, Children's National, Medical College of Wisconsin, University of Florida, Fred Hutch Cancer Center, University of Minnesota Medical Center, Hôpital Saint-Louis, Florida College
- ZWZhiwei Wang
Cleveland Clinic, UF Health Shands Hospital, Children's National, Medical College of Wisconsin, University of Florida, Fred Hutch Cancer Center, University of Minnesota Medical Center, Hôpital Saint-Louis, Florida College
- KAKathleen A. Sobocinski
Cleveland Clinic, UF Health Shands Hospital, Children's National, Medical College of Wisconsin, University of Florida, Fred Hutch Cancer Center, University of Minnesota Medical Center, Hôpital Saint-Louis, Florida College
Topics & keywords
- Medicine
- Transplantation
- Population
- Cause of death
- Disease
- Internal medicine
- Cohort
- Surgery
- Good health and well-being