Burden of Morbidity in 10+ Year Survivors of Hematopoietic Cell Transplantation: Report from the Bone Marrow Transplantation Survivor Study

Can Lan Sun, John H. Kersey, Liton Francisco, Saro H. Armenian, K. Scott Baker, Daniel J. Weisdorf, Stephen J. Forman, Smita Bhatia

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67 Scopus citations

Abstract

Long-term morbidity after hematopoietic cell transplantation (HCT) is unknown. The risk of physical and psychological health in 324 patients who had survived 10 or more years after HCT and a sibling comparison group (n= 309) was evaluated. Using the Common Terminology Criteria for Adverse Events, the 15-year cumulative incidence of severe/life-threatening/fatal conditions was 41% (95% confidence interval, 34% to 48%). HCT survivors were 5.7 times as likely to develop a severe/life-threatening condition (. P < .001) and 2.7times as likely to report somatic distress (. P < .001) compared with siblings. Compared with allogeneic HCT recipients with no chronic graft-versus-host disease (GVHD), those with active chronic GVHD were at a 1.8-fold higher risk of severe/life-threatening health conditions (. P= .006) and a 4.5-fold higher risk of somatic distress (. P= .04); allogeneic HCT recipients with resolved chronic GVHD were not at increased risk of morbidity compared with those with no chronic GVHD. Only 27% of the HCT survivors returned to the transplantation center for their cancer-related care. The burden of long-term physical and emotional morbidity borne by survivors remains substantial, even beyond 10 years after HCT; however, specialized health care is underused. Patients, families, and healthcare providers need to be made aware of the high burden, so they can plan for post-HCT care, even many years after HCT.

Original languageEnglish (US)
Pages (from-to)1073-1080
Number of pages8
JournalBiology of Blood and Marrow Transplantation
Volume19
Issue number7
DOIs
StatePublished - Jul 2013

Bibliographical note

Funding Information:
Financial disclosure: Supported in part by grants from the National Institutes of Health ( R01 CA078938 [to S.B.], P01 CA 30206 [to S.J.F.], K23 CA85503-01 [to K.S.B.]) and the Leukemia & Lymphoma Society ( 2192 ) (to S.B.).

Keywords

  • Health care utilization
  • Hematopoietic cell transplantation
  • Long term morbidity

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