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Blood, 15 November 2007, Vol. 110, No. 10, pp. 3784-3792. Prepublished online as a Blood First Edition Paper on August 1, 2007; DOI 10.1182/blood-2007-03-082933. This Article Full Text Full Text (PDF) All Versions of this Article: blood-2007-03-082933v1 110/10/3784    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Bhatia, S. Articles by Weisdorf, D. J. Search for Related Content PubMed PubMed Citation Articles by Bhatia, S. Articles by Weisdorf, D. J. Related Collections Transplantation Clinical Trials and Observations Related Articles in Blood Online Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  TRANSPLANTATION Late mortality after allogeneic hematopoietic cell transplantation and functional status of long-term survivors: report from the Bone Marrow Transplant Survivor Study Smita Bhatia1, Liton Francisco1, Andrea Carter1, Can-Lan Sun1, K. Scott Baker2, James G. Gurney3, Philip B. McGlave2, Auayporn Nademanee4, Margaret O'Donnell4, Norma K. C. Ramsay2, Leslie L. Robison5, David Snyder4, Anthony Stein4, Stephen J. Forman4, and Daniel J. Weisdorf2 1 Population Sciences, City of Hope National Medical Center, Duarte, CA; 2 Blood and Marrow Transplantation, University of Minnesota, Minneapolis; 3 Pediatrics, University of Michigan, Ann Arbor; 4 Hematology & Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA; and 5 Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, TN We assessed late mortality in 1479 individuals who had survived 2 or more years after allogeneic hematopoietic cell transplantation (HCT). Median age at HCT was 25.9 years and median length of follow-up was 9.5 years. The conditional survival probability at 15 years from HCT was 80.2% (SE = 1.9%) for those who were disease-free at entry into the cohort, and the relative mortality was 9.9 (95% confidence interval, 8.7-11.2). Relative mortality decreased with time from HCT, but remained significantly elevated at 15 years after HCT (standardized mortality ratio = 2.2). Relapse of primary disease (29%) and chronic graft-versus-host disease (cGVHD: 22%) were the leading causes of premature death. Nonrelapse-related mortality was increased among patients older than 18 years at HCT (18-45 years: relative risk [RR] = 1.7; 46+ years: RR = 3.7) and among those with cGVHD (RR = 2.7), and was lower among patients who received methotrexate for GVHD prophylaxis (RR = 0.5). HCT survivors were more likely to report difficulty in holding jobs (odds ratio [OR] = 13.9), and in obtaining health (OR = 7.1) or life (OR = 9.9) insurance compared with siblings. This study demonstrates that mortality rates remain twice as high as that of the general population among 15-year survivors of HCT, and that the survivors face challenges affecting their health and well-being. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? Related Articles in Blood Online: Physical and not mental health is impaired in very long-term survivors after HSCT compared with their respective donors: a paired analysis Alicia Rovó, Thomas Daikeler, Martin Stern, Jörg Halter, Jan Dirk Studt, Andreas Buser, Dominik Heim, Johannes Rischewski, Michael Medinger, Alan Tyndall, Alois Gratwohl, and André Tichelli Blood 2008 111: 1740-1741. [Full Text] [PDF] Hematopoietic cell transplantation: a lifelong commitment André Tichelli Blood 2007 110: 3493-3494. [Full Text] [PDF] This article has been cited by other articles: G. M. Baerlocher, A. Rovo, A. Muller, S. Matthey, M. Stern, J. Halter, D. Heim, J. Rischewski, A. Gratwohl, and A. Tichelli Cellular senescence of white blood cells in very long-term survivors after allogeneic hematopoietic stem cell transplantation: the role of chronic graft-versus-host disease and female donor sex Blood, July 2, 2009; 114(1): 219 - 222. [Abstract] [Full Text] [PDF] G. T. Armstrong, Q. Liu, Y. Yasui, J. P. Neglia, W. Leisenring, L. L. Robison, and A. C. Mertens Late Mortality Among 5-Year Survivors of Childhood Cancer: A Summary From the Childhood Cancer Survivor Study J. Clin. Oncol., May 10, 2009; 27(14): 2328 - 2338. [Abstract] [Full Text] [PDF] B. N. Savani, S. Goodman, and A. J. Barrett Can Routine Posttransplant HPV Vaccination Prevent Commonly Occurring Epithelial Cancers after Allogeneic Stem Cell Transplantation? Clin. Cancer Res., April 1, 2009; 15(7): 2219 - 2221. [Abstract] [Full Text] [PDF] S. Bhatia and L. L. Robison Cancer Survivorship Research: Opportunities and Future Needs for Expanding the Research Base Cancer Epidemiol. Biomarkers Prev., July 1, 2008; 17(7): 1551 - 1557. [Full Text] [PDF] A. Rovo, T. Daikeler, M. Stern, J. Halter, J. D. Studt, A. Buser, D. Heim, J. Rischewski, M. Medinger, A. Tyndall, et al. Physical and not mental health is impaired in very long-term survivors after HSCT compared with their respective donors: a paired analysis Blood, February 1, 2008; 111(3): 1740 - 1741. [Full Text] [PDF]

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