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Allogeneic HCT for AML: Long-Term Follow-up for Late Morbidities

By: Kayci Reyer
Posted: Tuesday, March 2, 2021

Research presented as correspondence in the American Journal of Hematology reported the “cost of long-term survival” for childhood survivors of acute myeloid leukemia (AML) who underwent allogeneic hematopoietic cell transplantation (allo-HCT) during first or second remission. Henrik Hasle, MD, of Aarhus University Hospital in Denmark, and colleagues compared hospitalizations rates among childhood survivors who underwent allo-HCT, childhood survivors who did not undergo allo-HCT, and the general population in Scandinavia.

“Our findings underline the necessity of long‐term follow‐up after allo-HCT that facilitates early detection of late morbidities and targeted lifestyle and medical interventions regardless of which conditioning regimen is used,” concluded the study authors.

The study included all 5-year survivors of childhood AML who had been diagnosed between July 1, 1984, and December 31, 2005, in Denmark, Finland, Iceland, or Sweden (n = 196), as well as a cohort from the general population with similar sex, age, and nationality (n = 152,231). Almost half (49%) of the childhood survivors had undergone allo-HCT; the remaining 51% had undergone chemotherapy alone. The median follow-up was 12 years after diagnosis for those receiving allo-HCT and 11 years after diagnosis for those receiving chemotherapy. A total of 61% of survivors who received allo-HCT had also been given total-body irradiation, and 38% had received allo-HCT in second complete remission.

Almost one-third of the survivor cohort had experienced at least one hospitalization for a somatic disease. A total of 36% of those who had undergone allo-HCT had been hospitalized at least once, with survivors receiving transplants during second complete remission with the highest rate (49%). Survivors who had received chemotherapy had a comparable hospitalization rate to the general population. Those undergoing allo-HCT during first complete remission experienced an increased hospitalization risk for endocrine, cardiovascular, respiratory, gastrointestinal, and digestive diseases, whereas those undergoing allo-HCT during second complete remission had an increased hospitalization risk for infectious disease and nervous system; bone, joints, and soft tissue; respiratory; gastrointestinal and digestive; and endocrine diseases.

Disclosure: The study authors reported no conflicts of interest.


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