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Late morbidity and mortality after autologous blood or marrow transplantation for lymphoma in children, adolescents and young adults—a BMTSS report

Holmqvist, Anna Sällfors LU ; Meng, Qingrui ; Dai, Chen ; Hageman, Lindsey ; Landier, Wendy ; Wu, Jessica ; Francisco, Liton F. ; Ross, Elizabeth Schlichting ; Balas, Nora and Bosworth, Alysia , et al. (2024) In Leukemia 38(3). p.601-609
Abstract

We determined the risk of late morbidity and mortality after autologous blood or marrow transplantation (BMT) for lymphoma performed before age 40. The cohort included autologous BMT recipients who had survived ≥2 years after transplantation (N = 583 [HL = 59.9%; NHL = 40.1%]) and a comparison cohort (N = 1070). Participants self-reported sociodemographics and chronic health conditions. A severity score (grade 3 [severe], 4 [life threatening] or 5 [fatal]) was assigned to the conditions using CTCAE v5.0. Logistic regression estimated the odds of grade 3–4 conditions in survivors vs. comparison subjects. Proportional subdistribution hazards models identified predictors of grade 3–5 conditions among BMT recipients. Median age at BMT was... (More)

We determined the risk of late morbidity and mortality after autologous blood or marrow transplantation (BMT) for lymphoma performed before age 40. The cohort included autologous BMT recipients who had survived ≥2 years after transplantation (N = 583 [HL = 59.9%; NHL = 40.1%]) and a comparison cohort (N = 1070). Participants self-reported sociodemographics and chronic health conditions. A severity score (grade 3 [severe], 4 [life threatening] or 5 [fatal]) was assigned to the conditions using CTCAE v5.0. Logistic regression estimated the odds of grade 3–4 conditions in survivors vs. comparison subjects. Proportional subdistribution hazards models identified predictors of grade 3–5 conditions among BMT recipients. Median age at BMT was 30.0 years (range: 2.0–40.0) and median follow-up was 9.8 years (2.0–32.1). Survivors were at a 3-fold higher adjusted odds for grade 3–4 conditions (95% CI = 2.3–4.1) vs. comparison subjects. Factors associated with grade 3–5 conditions among BMT recipients included age at BMT (>30 years: adjusted hazard ratio [aHR] = 2.31; 95% CI = 1.27–4.19; reference: ≤21 years), pre-BMT radiation (aHR = 1.52; 95% CI = 1.13–2.03; reference: non-irradiated), and year of BMT (≥2000: aHR = 0.54; 95% CI = 0.34–0.85; reference: <1990). The 25 years cumulative incidence of relapse-related and non-relapse-related mortality was 18.2% and 25.9%, respectively. The high risk for late morbidity and mortality after autologous BMT for lymphoma performed at age <40 calls for long-term anticipatory risk-based follow-up.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Leukemia
volume
38
issue
3
pages
9 pages
publisher
Nature Publishing Group
external identifiers
  • pmid:38374408
  • scopus:85185270754
ISSN
0887-6924
DOI
10.1038/s41375-024-02144-7
language
English
LU publication?
yes
id
42fc3dee-6ec5-4248-9530-51a153757d67
date added to LUP
2024-03-27 09:27:53
date last changed
2024-04-24 13:17:56
@article{42fc3dee-6ec5-4248-9530-51a153757d67,
  abstract     = {{<p>We determined the risk of late morbidity and mortality after autologous blood or marrow transplantation (BMT) for lymphoma performed before age 40. The cohort included autologous BMT recipients who had survived ≥2 years after transplantation (N = 583 [HL = 59.9%; NHL = 40.1%]) and a comparison cohort (N = 1070). Participants self-reported sociodemographics and chronic health conditions. A severity score (grade 3 [severe], 4 [life threatening] or 5 [fatal]) was assigned to the conditions using CTCAE v5.0. Logistic regression estimated the odds of grade 3–4 conditions in survivors vs. comparison subjects. Proportional subdistribution hazards models identified predictors of grade 3–5 conditions among BMT recipients. Median age at BMT was 30.0 years (range: 2.0–40.0) and median follow-up was 9.8 years (2.0–32.1). Survivors were at a 3-fold higher adjusted odds for grade 3–4 conditions (95% CI = 2.3–4.1) vs. comparison subjects. Factors associated with grade 3–5 conditions among BMT recipients included age at BMT (&gt;30 years: adjusted hazard ratio [aHR] = 2.31; 95% CI = 1.27–4.19; reference: ≤21 years), pre-BMT radiation (aHR = 1.52; 95% CI = 1.13–2.03; reference: non-irradiated), and year of BMT (≥2000: aHR = 0.54; 95% CI = 0.34–0.85; reference: &lt;1990). The 25 years cumulative incidence of relapse-related and non-relapse-related mortality was 18.2% and 25.9%, respectively. The high risk for late morbidity and mortality after autologous BMT for lymphoma performed at age &lt;40 calls for long-term anticipatory risk-based follow-up.</p>}},
  author       = {{Holmqvist, Anna Sällfors and Meng, Qingrui and Dai, Chen and Hageman, Lindsey and Landier, Wendy and Wu, Jessica and Francisco, Liton F. and Ross, Elizabeth Schlichting and Balas, Nora and Bosworth, Alysia and Te, Hok Sreng and Bhatia, Ravi and Rosenthal, Joseph and Wong, F. Lennie and Weisdorf, Daniel and Armenian, Saro H. and Bhatia, Smita}},
  issn         = {{0887-6924}},
  language     = {{eng}},
  number       = {{3}},
  pages        = {{601--609}},
  publisher    = {{Nature Publishing Group}},
  series       = {{Leukemia}},
  title        = {{Late morbidity and mortality after autologous blood or marrow transplantation for lymphoma in children, adolescents and young adults—a BMTSS report}},
  url          = {{http://dx.doi.org/10.1038/s41375-024-02144-7}},
  doi          = {{10.1038/s41375-024-02144-7}},
  volume       = {{38}},
  year         = {{2024}},
}