Late Mortality and Causes of Death among Long-Term Survivors after Allogeneic Stem Cell Transplantation

for the, Late Effect and Quality of Life Working Group of the Japan Society for Hematopoietic Cell Transplantation

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20 Citations (Scopus)

Abstract

We sought to assess the late mortality risks and causes of death among long-term survivors of allogeneic hematopoietic stem cell transplantation (HCT). The cases of 11,047 relapse-free survivors of a first HCT at least 2 years after HCT were analyzed. Standardized mortality ratios (SMR) were calculated and specific causes of death were compared with those of the Japanese population. Among relapse-free survivors at 2 years, overall survival percentages at 10 and 15 years were 87% and 83%, respectively. The overall risk of mortality was significantly higher compared with that of the general population. The risk of mortality was significantly higher from infection (SMR = 57.0), new hematologic malignancies (SMR = 2.2), other new malignancies (SMR = 3.0), respiratory causes (SMR = 109.3), gastrointestinal causes (SMR = 3.8), liver dysfunction (SMR = 6.1), genitourinary dysfunction (SMR = 17.6), and external or accidental causes (SMR = 2.3). The overall annual mortality rate showed a steep decrease from 2 to 5 years after HCT; however, the decrease rate slowed after 10 years but was still higher than that of the general population at 20 years after HCT. SMRs in the earlier period of 2 to 4 years after HCT and 5 years or longer after HCT were 16.1 and 7.4, respectively. Long-term survivors after allogeneic HCT are at higher risk of mortality from various causes other than the underlying disease that led to HCT. Screening and preventive measures should be given a central role in reducing the morbidity and mortality of HCT recipients on long-term follow-up.

Original languageEnglish
Pages (from-to)1702-1709
Number of pages8
JournalBiology of Blood and Marrow Transplantation
Volume22
Issue number9
DOIs
Publication statusPublished - 2016 Sep 1

Keywords

  • Causes of death
  • Late effects
  • Late mortality

ASJC Scopus subject areas

  • Hematology
  • Transplantation

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    for the, & Late Effect and Quality of Life Working Group of the Japan Society for Hematopoietic Cell Transplantation (2016). Late Mortality and Causes of Death among Long-Term Survivors after Allogeneic Stem Cell Transplantation. Biology of Blood and Marrow Transplantation, 22(9), 1702-1709. https://doi.org/10.1016/j.bbmt.2016.05.019