Health and functional status of adult recipients 1 year after allogeneic haematopoietic stem cell transplantation

Br J Haematol. 2001 Apr;113(1):194-201. doi: 10.1046/j.1365-2141.2001.02678.x.

Abstract

Increasing numbers of patients are surviving after allogeneic haematopoietic stem cell transplantation (SCT). Among these patients, a number of late complications have been described but few data on the risk factors of these long-term effects of SCT are available. We report the analysis on 105 adult patients, surviving free of haematological disease at a median time of 15 months after SCT. At the time of screening, 52% had returned to work, general health status was normal in 67% and 47% were sexually active. Female patient gender odds ratio (OR) 2.9 (P = 0.01) and age > 25 years (OR = 3.2, P = 0.02) were associated with non-return to work. Decreased general status was associated with chronic graft-versus-host disease (GvHD) (OR = 3.2, P = 0.009) and irradiation (OR = 3.6, P = 0.004). Sexual inactivity was associated with younger age (OR = 7.0, P = 0.0002) and chronic GvHD (OR = 3.3, P = 0.006). Risk factors for altered pulmonary function tests included previous smoking habits, irradiation and chronic GvHD. Obstructive lung disease was associated with a previous history of asthma. Sicca syndrome and conjunctivitis were increased in patients with previous acute GvHD and cataracts were less frequent in patients with aplastic anaemia. Persistent impaired hair re-growth was less frequent in patients who received irradiation (OR = 0.18, P = 0.002) but increased in patients with previous acute GvHD (OR = 5.3, P = 0.007). Microalbuminuria was more frequent in irradiated patients (OR = 9.4, P = 0.05). Raised cholesterol was associated with age (OR = 20.8, P < 0.001), previous acute GvHD (OR = 4.7, P = 0.03), steroid use (OR = 6.3, P = 0.001) and familial hypercholesterolaemia (OR = 4.4, P = 0.04). Decreased bone density was associated with chronic GvHD (OR = 3.9, P = 0.001). Thus, using routine tests in adult patients we were able to detect significant numbers of-non-symptomatic complications enabling early treatment.

MeSH terms

  • Acute Disease
  • Adult
  • Age Factors
  • Asthma / complications
  • Bone Density
  • Chi-Square Distribution
  • Cholesterol / blood
  • Chronic Disease
  • Coitus
  • Female
  • Follow-Up Studies
  • Graft vs Host Disease
  • Hematologic Neoplasms / radiotherapy
  • Hematologic Neoplasms / rehabilitation*
  • Hematologic Neoplasms / surgery
  • Hematopoietic Stem Cell Transplantation*
  • Humans
  • Likelihood Functions
  • Lung Diseases, Obstructive / etiology
  • Male
  • Odds Ratio
  • Sex Factors
  • Smoking / adverse effects
  • Time Factors
  • Transplantation, Homologous

Substances

  • Cholesterol