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Late effects after ablative allogeneic stem cell transplantation for adolescent and young adult acute myeloid leukemia.

Publication ,  Journal Article
Lee, CJ; Kim, S; Tecca, HR; Bo-Subait, S; Phelan, R; Brazauskas, R; Buchbinder, D; Hamilton, BK; Battiwalla, M; Majhail, NS; Lazarus, HM ...
Published in: Blood advances
March 2020

There is marked paucity of data regarding late effects in adolescents and young adults (AYAs) who undergo myeloablative conditioning (MAC) allogeneic hematopoietic cell transplantation (HCT) for acute myeloid leukemia (AML). We evaluated late effects and survival in 826 1-year disease-free survivors of MAC HCT for AYA AML, with an additional focus on comparing late effects based upon MAC type (total body irradiation [TBI] vs high-dose chemotherapy only). The estimated 10-year cumulative incidence of subsequent neoplasms was 4% (95% confidence interval [CI], 2%-6%); 10-year cumulative incidence of nonmalignant late effects included gonadal dysfunction (10%; 95% CI, 8%-13%), cataracts (10%; 95% CI, 7%-13%), avascular necrosis (8%; 95% CI, 5%-10%), diabetes mellitus (5%; 95% CI, 3%-7%), and hypothyroidism (3%; 95% CI, 2%-5%). Receipt of TBI was independently associated with a higher risk of cataracts only (hazard ratio [HR], 4.98; P < .0001) whereas chronic graft-versus-host disease (cGVHD) was associated with an increased risk of cataracts (HR, 3.22; P = .0006), avascular necrosis (HR, 2.49; P = .006), and diabetes mellitus (HR, 3.36; P = .03). Estimated 10-year overall survival and leukemia-free survival were 73% and 70%, respectively, and did not differ on the basis of conditioning type. In conclusion, late effects among survivors of MAC HCT for AYA AML are frequent and are more closely linked to cGVHD than type of conditioning.

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Published In

Blood advances

DOI

EISSN

2473-9537

ISSN

2473-9529

Publication Date

March 2020

Volume

4

Issue

6

Start / End Page

983 / 992

Related Subject Headings

  • Young Adult
  • Transplantation Conditioning
  • Recurrence
  • Leukemia, Myeloid, Acute
  • Humans
  • Hematopoietic Stem Cell Transplantation
  • Graft vs Host Disease
  • Adolescent
  • 3201 Cardiovascular medicine and haematology
 

Citation

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Lee, C. J., Kim, S., Tecca, H. R., Bo-Subait, S., Phelan, R., Brazauskas, R., … Muffly, L. S. (2020). Late effects after ablative allogeneic stem cell transplantation for adolescent and young adult acute myeloid leukemia. Blood Advances, 4(6), 983–992. https://doi.org/10.1182/bloodadvances.2019001126
Lee, Catherine J., Soyoung Kim, Heather R. Tecca, Stephanie Bo-Subait, Rachel Phelan, Ruta Brazauskas, David Buchbinder, et al. “Late effects after ablative allogeneic stem cell transplantation for adolescent and young adult acute myeloid leukemia.Blood Advances 4, no. 6 (March 2020): 983–92. https://doi.org/10.1182/bloodadvances.2019001126.
Lee CJ, Kim S, Tecca HR, Bo-Subait S, Phelan R, Brazauskas R, et al. Late effects after ablative allogeneic stem cell transplantation for adolescent and young adult acute myeloid leukemia. Blood advances. 2020 Mar;4(6):983–92.
Lee, Catherine J., et al. “Late effects after ablative allogeneic stem cell transplantation for adolescent and young adult acute myeloid leukemia.Blood Advances, vol. 4, no. 6, Mar. 2020, pp. 983–92. Epmc, doi:10.1182/bloodadvances.2019001126.
Lee CJ, Kim S, Tecca HR, Bo-Subait S, Phelan R, Brazauskas R, Buchbinder D, Hamilton BK, Battiwalla M, Majhail NS, Lazarus HM, Shaw PJ, Marks DI, Litzow MR, Chhabra S, Inamoto Y, DeFilipp Z, Hildebrandt GC, Olsson RF, Kasow KA, Liesveld JL, Rotz SJ, Badawy SM, Bhatt NS, Yared JA, Page KM, Arellano ML, Kent M, Farhadfar N, Seo S, Hematti P, Freytes CO, Rovó A, Ganguly S, Nathan S, Burns L, Shaw BE, Muffly LS. Late effects after ablative allogeneic stem cell transplantation for adolescent and young adult acute myeloid leukemia. Blood advances. 2020 Mar;4(6):983–992.

Published In

Blood advances

DOI

EISSN

2473-9537

ISSN

2473-9529

Publication Date

March 2020

Volume

4

Issue

6

Start / End Page

983 / 992

Related Subject Headings

  • Young Adult
  • Transplantation Conditioning
  • Recurrence
  • Leukemia, Myeloid, Acute
  • Humans
  • Hematopoietic Stem Cell Transplantation
  • Graft vs Host Disease
  • Adolescent
  • 3201 Cardiovascular medicine and haematology