The challenge of long-term follow-up of survivors of childhood acute leukemia after hematopoietic stem cell transplantation in resource-limited countries: A single-center report from Brazil.
Adolescent
Brazil
Cancer Survivors
Child
Child, Preschool
Cross-Sectional Studies
Female
Follow-Up Studies
Graft vs Host Disease
/ epidemiology
Health Resources
Hematopoietic Stem Cell Transplantation
Humans
Infant
Leukemia, Myeloid, Acute
/ surgery
Male
Postoperative Complications
/ epidemiology
Retrospective Studies
Time Factors
acute leukemia
child
effects
hematopoietic stem cell transplantation
quality of life
Journal
Pediatric transplantation
ISSN: 1399-3046
Titre abrégé: Pediatr Transplant
Pays: Denmark
ID NLM: 9802574
Informations de publication
Date de publication:
06 2020
06 2020
Historique:
received:
12
11
2019
revised:
30
01
2020
accepted:
18
02
2020
pubmed:
5
4
2020
medline:
10
8
2021
entrez:
5
4
2020
Statut:
ppublish
Résumé
With the number of long-term HSCT survivors steadily increasing, attention needs to be focused on the late complications and quality of life. We therefore analyzed the outcome of 101 pediatric patients (<18 years old at the time of HSCT) transplanted for acute leukemia between 1981 and 2015 at Complexo Hospital de Clínicas, Federal University of Paraná, Brazil, and who survived at least two years after HSCT. The median follow-up was 5.9 years (2.0-29.0); median age at follow-up was 17.5 years (2.98-39.0). The 5-year cumulative incidence of relapse was 27.5% (95% CI 18.6%-36.4%). Two-year cumulative incidence of chronic GVHD was 21.8% (95% CI 13.7%-29.8%). Of the 101 patients, 72 patients (71.3%) presented with late effects. Those surviving longer after HSCT experienced more complications. Patients who received TBI-based regimen developed more late effects (P = .013) and more endocrinological complications (P = .024). Endocrinological complications were the most common late sequelae found in this study. For childhood survivors, quality of life was not influenced by age (at HSCT or at last visit), time from HSCT, gender, donor, or GVHD. For survivors that no longer were children, only age at last visit impacted financial domain measures, irrespective of gender, donor, or GVHD. The current study confirms the high burden late complications after pediatric HSCT have on the survivors and underlines the importance of extended follow-up.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e13691Informations de copyright
© 2020 Wiley Periodicals, Inc.
Références
Chow EJ, Anderson L, Baker KS, et al. Late effects surveillance recommendations among survivors of childhood hematopoietic cell transplantation: a Children’s Oncology Group Report. Biol Blood Marrow Transpl. 2016;22(5):782-795.
Vrooman LM, Millard HR, Brazauskas R, et al. Survival and late effects after allogeneic hematopoietic cell transplantation for hematologic malignancy at less than three years of age. Biol Blood Marrow Transplant. 2017;23(8):1327-1334.
Baker KS, Bresters D, Sande JE. The burden of cure: long-term side effects following hematopoietic stem cell transplantation (HSCT) in children. Pediatr Clin N Am. 2010;57(1):323-342.
Majhail NS, Douglas Rizzo J, Lee SJ, et al. Recommended screening and preventive practices for long-term survivors after hematopoietic cell transplantation. Hematol Oncol Stem Cell Ther. 2012;5(1):1-30.
Lawitschka A, Peters C. Long-term effects of myeloablative allogeneic hematopoietic stem cell transplantation in pediatric patients with acute lymphoblastic leukemia. Curr Oncol Rep. 2018;20(9):74.
Bhatia S. Late effects among survivors of leukemia during childhood and adolescence. Blood Cells Mol Dis. 2003;31(1):84-92.
Bhatia S, Armenian SH, Landier W. How I monitor long-term and late effects after blood or marrow transplantation. Blood. 2017;130(11):1302-1314.
Arai S, Arora M, Wang T, et al. Increasing incidence of chronic graft-versus-host disease in allogeneic transplantation: a report from the center for international blood and marrow transplant research. Biol Blood Marrow Transplant. 2015;21(2):266-274.
Kato M, Kurata M, Kanda J, et al. Impact of graft-versus-host disease on relapse and survival after allogeneic stem cell transplantation for pediatric leukemia. Bone Marrow Transplant. 2019;54(1):68-75.
Berbis J, Michel G, Chastagner P, et al. A French Cohort of childhood leukemia survivors: impact of hematopoietic stem cell transplantation on health status and quality of life. Biol Blood Marrow Transplant. 2013;19(7):1065-1072.
Bevans M, El-Jawahri A, Tierney DK, et al. National Institutes of health hematopoietic cell transplantation late effects initiative: the patient-centered outcomes working group report. Biol Blood Marrow Transplant. 2017;23(4):538-551.
Varni JW, Limbers CA, Burwinkle TM. Impaired health-related quality of life in children and adolescents with chronic conditions: a comparative analysis of 10 disease clusters and 33 disease categories/severities utilizing the PedsQLTM 4.0 Generic Core Scales. Health Qual Life Outcomes. 2007;5(43):1-15. https://doi.org/10.1186/1477-7525-5-43
Klatchoian DA, Len CA, Terreri MTRA, et al. Quality of life of children and adolescents from São Paulo: reliability and validity of the Brazilian version of the Pediatric Quality of Life Inventory™ version 4.0 Generic Core Scales. J Pediatr. 2008;84(4):308-315.
Aaronson NK, Ahmedzai S, Bergman B, et al. The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst. 1993;85(5):365-376.
Baker KS, Ness KK, Weisdorf D, et al. Late effects in survivors of acute leukemia treated with hematopoietic cell transplantation: a report from the Bone Marrow Transplant Survivor Study. Leukemia. 2010;24(12):2039-2047.
Filipovich AH, Weisdorf D, Pavletic S, et al. National Institutes of health consensus development project on criteria for clinical trials in chronic graft-versus-host disease: I. Diagnosis and staging working group report. Biol Blood Marrow Transplant. 2005;11(12):945-955.
Jagasia MH, Greinix HT, Arora M, et al. National Institutes of Health Consensus Development Project on Criteria for Clinical Trials in Chronic Graft-versus-Host Disease: I. The 2014 Diagnosis and Staging Working Group Report. Biol Blood Marrow Transplant. 2015;21(3):389-401.
Ishiguro H, Yasuda Y, Hyodo H, et al. Growth and endocrine function in long-term adult survivors of childhood stem cell transplant. Clin Pediatr Endocrinol. 2009;18(1):1-14.
Shalitin S, Pertman L, Yackobovitch-Gavan M, et al. Endocrine and metabolic disturbances in survivors of hematopoietic stem cell transplantation in childhood and adolescence. Horm Res Paediatr. 2018;89(2):108-121.
Bajwa R, Skeens M, Garee A, et al. Metabolic syndrome and endocrine dysfunctions after HSCT in children. Pediatr Transplant. 2012;16(8):872-878.
DeFilipp Z, Duarte RF, Snowden JA, et al. Metabolic syndrome and cardiovascular disease after hematopoietic cell transplantation: screening and preventive practice recommendations from the CIBMTR and EBMT. Biol Blood Marrow Transplant. 2016;22(8):1493-1503.
Baker KS, Chow E, Steinberger J. Metabolic syndrome and cardiovascular risk in survivors after hematopoietic cell transplantation. Bone Marrow Transplant. 2012;47(5):619-625.
Perkins JL, Kunin-Batson AS, Youngren NM, et al. Long-term follow-up of children who underwent hematopoietic cell transplant (HCT) for AML or ALL at less than 3 years of age. Pediatr Blood Cancer. 2007;49(7):958-963.
Landier W, Armenian S, Bhatia S. Late effects of childhood cancer and its treatment. Pediatr Clin North Am. 2015;62(1):275-300.
Loonen JJ, Blijlevens NMA, Prins J, et al. Cancer survivorship care: person centered care in a multidisciplinary shared care model. Int J Integr Care. 2018;18(1):1-7.
Ferry C, Gemayel G, Rocha V, et al. Long-term outcomes after allogeneic stem cell transplantation for children with hematological malignancies. Bone Marrow Transplant. 2007;40(3):219-224.
Levy JMM, Tello T, Giller R, et al. Late effects of total body irradiation and hematopoietic stem cell transplant in children under 3 years of age. Pediatr Blood Cancer. 2013;60(4):700-704.
Bresters D, Lawitschka A, Cugno C, et al. Incidence and severity of crucial late effects after allogeneic HSCT for malignancy under the age of 3 years: TBI is what really matters. Bone Marrow Transplant. 2016;51(11):1482-1489.
Faraci M, Békássy AN, De Fazio V, Tichelli A, Dini G, on behalf of the EBMT Paediatric and Late Effects Working Parties. Non-endocrine late complications in children after allogeneic haematopoietic SCT. Bone Marrow Transplant. 2008;41(Supp. 2):S49-S57.
Socié G, Baker KS, Bhatia S. Subsequent malignant neoplasms after hematopoietic cell transplantation. Biol Blood Marrow Transplant. 2012;18(Suppl. 1):S139-S150.
Morton LM, Saber W, Baker KS, et al. National Institutes of Health hematopoietic cell transplantation late effects initiative: the subsequent neoplasms working group report. Biol Blood Marrow Transpl. 2017;23(3):367-378.
Berger C, Le-Gallo B, Donadieu J, et al. Late thyroid toxicity in 153 long-term survivors of allogeneic bone marrow transplantation for acute lymphoblastic leukaemia. Bone Marrow Transplant. 2005;35(10):991-995.
Shalitin S, Phillip M, Stein J, Goshen Y, Carmi D, Yaniv I. Endocrine dysfunction and parameters of the metabolic syndrome after bone marrow transplantation during childhood and adolescence. Bone Marrow Transplant. 2006;37(12):1109-1117.
Children’s Oncology Group. Long-Term Follow-Up Guidelines for Survivors of Childhood, Adolescent and Young Adult Cancers, Version 5.0. Monrovia CA: Children’s Oncology Group. Available at: http://www.survivorshipguidelines.org; 2018. Accessed July 1, 2019.
The European Society for Paediatric Oncology. The SIOPE Strategic Plan. A European Cancer Plan for Children and Adolescents. Brussels, Belgium: SIOP Europe. Available at: https://www.siope.eu/SIOPE_StrategicPlan2015/; 2015. Accessed September 15, 2019.
Lucchini G, Labopin M, Beohou E, et al. Impact of conditioning regimen on outcomes for children with acute myeloid leukemia undergoing transplantation in first complete remission. An analysis on behalf of the Pediatric Disease Working Party of the European Group for Blood and Marrow Transplantation. Biol Blood Marrow Transpl. 2017;23(3):467-474.
Kato K, Kato M, Hasegawa D, et al. Comparison of transplantation with reduced and myeloablative conditioning for children with acute lymphoblastic leukemia. Blood. 2015;125(8):1352-1354.
Pidala J, Kurland B, Chai X, et al. Patient-reported quality of life is associated with severity of chronic graft-versus-host disease as measured by NIH criteria: report on baseline data from the Chronic GVHD Consortium. Blood. 2011;17(17):4651-4657.
Majhail NS, Rizzo D. Surviving the cure: long term follow-up oh hematopoietic cell transplant recipientes. Bone Marrow Transplant. 2013;48(9):1145-1151.
Jernberg AG, Remberger M, Ringdén O, Winiarski J. Graft-versus-leukaemia effect in children: chronic GVHD has a significant impact on relapse and survival. Bone Marrow Transplant. 2003;31(3):175-181.
Armstrong GT, Chen Y, Yasui Y, et al. Reduction in late mortality among 5-year survivors of childhood cancer. N Engl J Med. 2016;374(9):833-842.
Armenian SH, Chemaitilly W, Chen M, et al. National Institutes of Health cell transplantation late effects initiative: the cardiovascular disease and associated risk factors working group report. Biol Blood Marrow Transplant. 2017;23(2):201-210.
Duncan CN, Brazauskas R, Huang J, et al. Late cardiovascular morbidity and mortality following pediatric allogeneic hematopoietic cell transplantation. Bone Marrow Transplant. 2018;53(10):1278-1287.
Nieder ML, McDonald GB, Kida A, et al. National Cancer Institute-National Heart, Lung and Blood Institute/Pediatric Blood and Marrow Transplant Consortium First International Consensus Conference on late effects after pediatric hematopoietic cell transplantation: long-term organ damage and dysfunction. Biol Blood Marrow Transpl. 2011;17(11):1573-1584.
Sundberg KK, Wettwergren L, Frisk P, Arvidson J. Self-reported quality of life in long-term survivors of childhood lymphoblastic malignancy treated with hematopoietic stem cell transplantation versus conventional therapy. Pediatr Blood Cancer. 2013;60(8):1382-1387.
Parsons SK, Phipps S, Sung L, Baker KS, Pulshipher MA, Ness KK. NCI, NHLBI/PBMTC First International Conference on late effects after pediatric hematopoietic cell transplantation: health-related quality of life, functional, and neurocognitive outcomes. Biol Blood Marrow Transpl. 2012;18(2):162-171.
Sinatora F, Traverso A, Zanato S, et al. Quality of life and psychopathology in adults who underwent hematopoietic stem cell transplantation (HSCT) in childhood: a qualitative and quantitative analysis. Front Psychol. 2017;8:1316.
Frobisher C, Glaser A, Levitt GA, et al. Risk stratification of childhood cancer survivors necessary for evidence-based clinical long-term follow-up. Br J Cancer. 2017;117(11):1723-1731.
Gale RP, Seber A, Bonfim C, Pasquini M. Haematopoietic cell transplants in Latin America. Bone Marrow Transplant. 2016;51(7):898-905.
Signorelli C, Wakefield CE, Fardell JE, et al. The role of primary care physicians in childhood cancer survivorship care: multiperspective interviews. Oncologist. 2019;24(5):710-719.
Eckrich M, Pasquini M. Hematopoietic cell transplantation In Latin America. Hematology. 2012;17(Supp. 1):S189-S191.