Late non-relapse mortality among adult autologous stem cell transplant recipients: a nation-wide analysis of 1,482 patients transplanted in 1990-2003

Eur J Haematol. 2006 Aug;77(2):114-9. doi: 10.1111/j.1600-0609.2006.00685.x.

Abstract

Data on the incidence and causes of late (>100 d) non-relapse mortality (NRM) in autologous stem cell transplant (ASCT) recipients is limited. We have analysed NRM in a cohort of 1,482 adult patients who received ASCT in 1990-2003 in six Finnish transplant centres. The most common diagnoses included non-Hodgkin's lymphoma (NHL) (n = 542), multiple myeloma (MM) (n = 528), breast cancer (n = 132); Hodgkin's lymphoma (HL) (n = 86) and chronic lymphocytic leukaemia (CLL) (n = 63). Until September 2005, 646 patients (44%) have died. Late NRM was observed in 68 patients (4.6% of ASCT recipients; 11% of all deaths). There were 38 males and 30 females with a median age of 58 yr (20-69) at the time of ASCT. The median time to NRM was 27 months from ASCT (3-112). The risk of NRM was highest in patients with CLL (9.5%) and those with HL (8.1%) followed by MM and NHL (4.9% and 4.8%, respectively). The risk of late NRM was comparable in patients who received total body irradiation (TBI) and those who received chemotherapy-only regimens (6.7% vs. 4.3%). Another malignancy was the most common cause of late NRM (24 patients, 35% of late NRM). Twelve patients (0.8% of ASCT recipients) have died due to secondary haematological malignancy. Altogether 22 patients (32% of late NRM) died from infectious causes. Malignancies and late infections are important causes of NRM after ASCT. These facts point out the importance of prolonged follow-up in ASCT recipients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Breast Neoplasms / drug therapy
  • Breast Neoplasms / surgery
  • Cardiovascular Diseases / mortality
  • Cause of Death
  • Cohort Studies
  • Combined Modality Therapy
  • Female
  • Finland / epidemiology
  • Follow-Up Studies
  • Hodgkin Disease / drug therapy
  • Hodgkin Disease / surgery
  • Humans
  • Infections / mortality
  • Leukemia, Lymphocytic, Chronic, B-Cell / drug therapy
  • Leukemia, Lymphocytic, Chronic, B-Cell / surgery
  • Lymphoma, Non-Hodgkin / drug therapy
  • Lymphoma, Non-Hodgkin / surgery
  • Male
  • Middle Aged
  • Multiple Myeloma / drug therapy
  • Multiple Myeloma / surgery
  • Neoplasms / mortality
  • Neoplasms / surgery*
  • Neoplasms, Second Primary / mortality
  • Peripheral Blood Stem Cell Transplantation / mortality
  • Peripheral Blood Stem Cell Transplantation / statistics & numerical data*
  • Postoperative Complications / mortality*
  • Transplantation Conditioning / mortality
  • Transplantation, Autologous / mortality
  • Transplantation, Autologous / statistics & numerical data
  • Whole-Body Irradiation / adverse effects