Late effects after ablative allogeneic stem cell transplantation for adolescent and young adult acute myeloid leukemia.

Lee, Catherine J; Kim, Soyoung; Tecca, Heather R; Bo-Subait, Stephanie; Phelan, Rachel; Brazauskas, Ruta; Buchbinder, David; Hamilton, Betty K; Battiwalla, Minoo; Majhail, Navneet S; Lazarus, Hillard M; Shaw, Peter J; Marks, David I; Litzow, Mark R; Chhabra, Saurabh; Inamoto, Yoshihiro; DeFilipp, Zachariah; Hildebrandt, Gerhard C; Olsson, Richard F; Kasow, Kimberly A; ... (2020). Late effects after ablative allogeneic stem cell transplantation for adolescent and young adult acute myeloid leukemia. Blood advances, 4(6), pp. 983-992. American Society of Hematology 10.1182/bloodadvances.2019001126

[img] Text
Late.pdf - Published Version
Restricted to registered users only
Available under License Publisher holds Copyright.

Download (758kB) | Request a copy

There is marked paucity of data regarding late effects in adolescents and young adults (AYAs) who undergo myeloablative conditioning (MAC) allogeneic hematopoietic cell transplantation (HCT) for acute myeloid leukemia (AML). We evaluated late effects and survival in 826 1-year disease-free survivors of MAC HCT for AYA AML, with an additional focus on comparing late effects based upon MAC type (total body irradiation [TBI] vs high-dose chemotherapy only). The estimated 10-year cumulative incidence of subsequent neoplasms was 4% (95% confidence interval [CI], 2%-6%); 10-year cumulative incidence of nonmalignant late effects included gonadal dysfunction (10%; 95% CI, 8%-13%), cataracts (10%; 95% CI, 7%-13%), avascular necrosis (8%; 95% CI, 5%-10%), diabetes mellitus (5%; 95% CI, 3%-7%), and hypothyroidism (3%; 95% CI, 2%-5%). Receipt of TBI was independently associated with a higher risk of cataracts only (hazard ratio [HR], 4.98; P < .0001) whereas chronic graft-versus-host disease (cGVHD) was associated with an increased risk of cataracts (HR, 3.22; P = .0006), avascular necrosis (HR, 2.49; P = .006), and diabetes mellitus (HR, 3.36; P = .03). Estimated 10-year overall survival and leukemia-free survival were 73% and 70%, respectively, and did not differ on the basis of conditioning type. In conclusion, late effects among survivors of MAC HCT for AYA AML are frequent and are more closely linked to cGVHD than type of conditioning.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Haematology and Central Haematological Laboratory

UniBE Contributor:

Rovó, Alicia

Subjects:

600 Technology > 610 Medicine & health

ISSN:

2473-9529

Publisher:

American Society of Hematology

Language:

English

Submitter:

Pierrette Durand Lüthi

Date Deposited:

15 Jun 2020 08:42

Last Modified:

15 Jun 2020 08:42

Publisher DOI:

10.1182/bloodadvances.2019001126

PubMed ID:

32168378

BORIS DOI:

10.7892/boris.144471

URI:

https://boris.unibe.ch/id/eprint/144471

Actions (login required)

Edit item Edit item
Provide Feedback