Late Effects in Survivors of Hodgkin’s and Non-Hodgkin’s Lymphoma Treated with Autologous Hematopoietic Cell Transplantation

摘要

We determined the prevalence of self-reported late-effects in survivors of autologous hematopoietic-cell transplantation (HCT) for Hodgkin’s lymphoma (HL, n=92) and non-Hodgkin’s lymphoma (NHL, n=184) using a 255-item questionnaire and compared them to 319 sibling controls in the Bone Marrow Transplant Survivor Study. Median age at HCT was 39 years (range, 13-69) and median post-transplant followup was 6 years (range, 2-17). Median age at survey was 46 years (range, 21-73) for survivors and 44 years (range, 19-79) for siblings. Compared to siblings, HCT survivors reported a significantly higher frequency of cataracts, dry mouth, hypothyroidism, bone impairments (osteoporosis and avascular necrosis), congestive heart failure, exercise-induced shortness of breath, neurosensory impairments, inability to attend work or school and poor overall health. Compared to those receiving no total-body irradiation (TBI), patients treated with TBI-based conditioning had higher risks of cataracts (odds-ratio (OR) 4.9, 95%CI 1.5-15.5) and dry mouth (OR 3.4, 95%CI 1.1-10.4). Females had a greater likelihood of reporting osteoporosis (OR 8.7, 95%CI: 1.8-41.7), congestive heart failure (OR 4.3, 95%CI 1.1-17.2) and abnormal balance, tremor or weakness (OR 2.4, 95%CI 1.0-5.5). HL and NHL survivors of autologous HCT have a high prevalence of long-term health-related complications and require continued monitoring for late-effects of transplantation.