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Blood, 15 September 2004, Vol. 104, No. 6, pp. 1898-1906.
Prepublished online as a Blood First Edition Paper on June 1, 2004; DOI 10.1182/blood-2004-03-1010.
 Previous Article | Next Article 
Submitted March 18, 2004
Accepted April 29, 2004
Late Effects In Survivors Of Chronic Myeloid Leukemia Treated with Hematopoietic Cell Transplant: Results from the Bone Marrow Transplant Survivor Study
K S Baker*, James G Gurney, Kirsten K Ness, Ravi Bhatia, Stephen J Forman, Liton Franscisco, Phillip B McGlave, Leslie L Robison, David S Snyder, Daniel J Weisdorf, and Smita Bhatia
Department of Pediatrics, University of Minnesota Cancer Center, Blood and Marrow Transplant Program, Minneapolis, MN, USA
Hematology and Hematology/ Bone Marrow Transplant, City of Hope Cancer Center, Duarte, CA, USA
Department of Internal Medicine, University of Minnesota Cancer Center, Blood and Marrow Transplant Program, Minneapolis, MN, USA
* Corresponding author; email: baker084{at}tc.umn.edu.
The purpose of this study was to analyze medical late effects among patients with CML treated with hematopoietic cell transplant (HCT). Subjects included 248 CML survivors who received HCT, [related donor(RD) n=150, unrelated donor (URD) n=70, or autologous n=28]; had survived at least 2 years; and a comparison group of 317 siblings. Subjects completed a 238-item survey on medical late effects. Compared with siblings, survivors were at a higher risk of developing ocular, oral health, endocrine, gastrointestinal, musculoskeletal, neurosensory and neuromotor impairments. Multivariate analysis limited to RD and URD recipients found cGVHD associated with a higher risk of hypothyroidism, osteoporosis, cardiopulmonary, neurosensory and neuromotor impairments. Overall health was reported as excellent, very good or good in 78% of subjects, although those with cGVHD were more likely to report poor overall health. URD survivors were more likely to report a need for assistance with routine activities and that their current health prevented work or school attendance. This study demonstrates that HCT survivors, regardless of donor type, have a high prevalence of long-term health-related complications. However, adverse medical late effects with significant morbidity were uncommon. Chronic GVHD is the most important predictor of adverse medical late effects and poor overall health.
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