Incidence and severity of crucial late effects after allogeneic HSCT for malignancy under the age of 3 years: TBI is what really matters.
Identifieur interne : 003768 ( Ncbi/Checkpoint ); précédent : 003767; suivant : 003769Incidence and severity of crucial late effects after allogeneic HSCT for malignancy under the age of 3 years: TBI is what really matters.
Auteurs : D. Bresters [Pays-Bas] ; A. Lawitschka [Autriche] ; C. Cugno [Italie] ; U. Pötschger [Autriche] ; A. Dalissier [France] ; G. Michel [France] ; K. Vettenranta [Finlande] ; M. Sundin [Suède] ; A. Al-Seraihy [Arabie saoudite] ; M. Faraci [Italie] ; P. Sedlacek [République tchèque] ; A B Versluys [Pays-Bas] ; A. Jenkins [Royaume-Uni] ; P. Lutz [France] ; B. Gibson [Royaume-Uni] ; A. Leiper [Royaume-Uni] ; M A Diaz [Espagne] ; P J Shaw [Australie] ; R. Skinner [Royaume-Uni] ; T A O'Brien [Australie] ; N. Salooja [Royaume-Uni] ; P. Bader [Allemagne] ; C. Peters [Autriche]Source :
- Bone marrow transplantation [ 1476-5365 ] ; 2016.
Abstract
Younger children are considered to be more vulnerable to late effects (LE), which prompted us to study LE in patients after haematopoietic stem cell transplantation (HSCT) for a haematological malignancy before the age of 3. In this multicentre EBMT study, cumulative incidence (CI) and severity of endocrine LE, central nervous system complications and secondary malignancies at 5, 10, 15 and 20 years of follow-up were assessed. Risk factors (RF) like gender, diagnosis, age at and year of HSCT, TBI- or chemo-conditioning and GVHD were analysed. CI of any LE was 0.30, 0.52, 0.66 and 0.72 at 5, 10, 15 and 20 years after HSCT, respectively. In 25% of the patients, LE were severe at a median follow-up of 10.4 years. In multivariate analysis, only TBI was a RF for having any LE and for thyroid dysfunction and growth disturbance. Female gender was a RF for delayed pubertal development. Some more insight could be gained by descriptive analysis regarding the role of TBI and GVHD on the severity of LE. Although only five selected LE have been studied and median follow-up is relatively short, the incidence and severity of these LE are considerable but not different from what has been found in older children and TBI is the main RF.
DOI: 10.1038/bmt.2016.139
PubMed: 27348540
Affiliations:
- Allemagne, Arabie saoudite, Australie, Autriche, Espagne, Finlande, France, Italie, Pays-Bas, Royaume-Uni, République tchèque, Suède
- Alsace (région administrative), Angleterre, Bohême centrale, Communauté de Madrid, District de Darmstadt, Grand Est, Grand Londres, Hesse (Land), Hollande-Méridionale, Provence-Alpes-Côte d'Azur, Svealand, Utrecht (province), Uusimaa, Vienne (Autriche), Île-de-France
- Francfort-sur-le-Main, Helsinki, Leyde, Londres, Madrid, Marseille, Paris, Prague, Stockholm, Strasbourg, Utrecht, Vienne (Autriche)
- Université d'Helsinki
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Vettenranta</name><affiliation wicri:level="4"><nlm:affiliation>Hospital for Children & Adolescents, University of Helsinki, Helsinki, Finland.</nlm:affiliation><country xml:lang="fr">Finlande</country><wicri:regionArea>Hospital for Children & Adolescents, University of Helsinki, Helsinki</wicri:regionArea><orgName type="university">Université d'Helsinki</orgName><placeName><settlement type="city">Helsinki</settlement><region type="région" nuts="2">Uusimaa</region></placeName></affiliation></author><author><name sortKey="Sundin, M" sort="Sundin, M" uniqKey="Sundin M" first="M" last="Sundin">M. Sundin</name><affiliation wicri:level="3"><nlm:affiliation>Department of Hematology/Immunology/SCT, Astrid Lindgren Children's Hospital, Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden.</nlm:affiliation><country xml:lang="fr">Suède</country><wicri:regionArea>Department of Hematology/Immunology/SCT, Astrid Lindgren Children's Hospital, Karolinska University Hospital and Karolinska Institutet, Stockholm</wicri:regionArea><placeName><settlement type="city">Stockholm</settlement><region nuts="2">Svealand</region></placeName></affiliation></author><author><name sortKey="Al Seraihy, A" sort="Al Seraihy, A" uniqKey="Al Seraihy A" first="A" last="Al-Seraihy">A. Al-Seraihy</name><affiliation wicri:level="1"><nlm:affiliation>Department of Paediatric Haematology/Oncology, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia.</nlm:affiliation><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>Department of Paediatric Haematology/Oncology, King Faisal Specialist Hospital & Research Centre, Riyadh</wicri:regionArea><wicri:noRegion>Riyadh</wicri:noRegion></affiliation></author><author><name sortKey="Faraci, M" sort="Faraci, M" uniqKey="Faraci M" first="M" last="Faraci">M. Faraci</name><affiliation wicri:level="1"><nlm:affiliation>Pediatric Hematology and Oncology HSCT Unit, Instituto G Gaslini, Genova, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Pediatric Hematology and Oncology HSCT Unit, Instituto G Gaslini, Genova</wicri:regionArea><wicri:noRegion>Genova</wicri:noRegion></affiliation></author><author><name sortKey="Sedlacek, P" sort="Sedlacek, P" uniqKey="Sedlacek P" first="P" last="Sedlacek">P. Sedlacek</name><affiliation wicri:level="3"><nlm:affiliation>Department of Paediatric Haematology & Oncology, University Hospital Motol, Prague, Czech Republic.</nlm:affiliation><country xml:lang="fr">République tchèque</country><wicri:regionArea>Department of Paediatric Haematology & Oncology, University Hospital Motol, Prague</wicri:regionArea><placeName><settlement type="city">Prague</settlement><region type="région" nuts="2">Bohême centrale</region></placeName></affiliation></author><author><name sortKey="Versluys, A B" sort="Versluys, A B" uniqKey="Versluys A" first="A B" last="Versluys">A B Versluys</name><affiliation wicri:level="3"><nlm:affiliation>Wilhelmina Children's Hospital, UMCU, Utrecht, The Netherlands.</nlm:affiliation><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Wilhelmina Children's Hospital, UMCU, Utrecht</wicri:regionArea><placeName><settlement type="city">Utrecht</settlement><region nuts="2" type="province">Utrecht (province)</region></placeName></affiliation></author><author><name sortKey="Jenkins, A" sort="Jenkins, A" uniqKey="Jenkins A" first="A" last="Jenkins">A. Jenkins</name><affiliation wicri:level="1"><nlm:affiliation>Department of Pediatric Oncology/Haematology, Sheffield Children's Hospital NHS Foundation Trust, Sheffield, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Pediatric Oncology/Haematology, Sheffield Children's Hospital NHS Foundation Trust, Sheffield</wicri:regionArea><wicri:noRegion>Sheffield</wicri:noRegion></affiliation></author><author><name sortKey="Lutz, P" sort="Lutz, P" uniqKey="Lutz P" first="P" last="Lutz">P. Lutz</name><affiliation wicri:level="3"><nlm:affiliation>Department of Pediatric Hematology Oncology, Nouvel Hopital Civil, Strasbourg, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Department of Pediatric Hematology Oncology, Nouvel Hopital Civil, Strasbourg</wicri:regionArea><placeName><region type="region">Grand Est</region><region type="old region">Alsace (région administrative)</region><settlement type="city">Strasbourg</settlement></placeName></affiliation></author><author><name sortKey="Gibson, B" sort="Gibson, B" uniqKey="Gibson B" first="B" last="Gibson">B. Gibson</name><affiliation wicri:level="1"><nlm:affiliation>Department of Haematology, Royal Hospital for Sick Children, Glasgow, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Haematology, Royal Hospital for Sick Children, Glasgow</wicri:regionArea><wicri:noRegion>Glasgow</wicri:noRegion></affiliation></author><author><name sortKey="Leiper, A" sort="Leiper, A" uniqKey="Leiper A" first="A" last="Leiper">A. Leiper</name><affiliation wicri:level="3"><nlm:affiliation>Department of BMT, Great Ormond Street Hospital for Children Foundation Trust, London, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of BMT, Great Ormond Street Hospital for Children Foundation Trust, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Diaz, M A" sort="Diaz, M A" uniqKey="Diaz M" first="M A" last="Diaz">M A Diaz</name><affiliation wicri:level="3"><nlm:affiliation>Hematopoietic Stem Cell Transplant and Cell Therapy Unit, Children's Hospital Niño Jesus, Madrid, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Hematopoietic Stem Cell Transplant and Cell Therapy Unit, Children's Hospital Niño Jesus, Madrid</wicri:regionArea><placeName><settlement type="city">Madrid</settlement><region nuts="2" type="region">Communauté de Madrid</region></placeName></affiliation></author><author><name sortKey="Shaw, P J" sort="Shaw, P J" uniqKey="Shaw P" first="P J" last="Shaw">P J Shaw</name><affiliation wicri:level="1"><nlm:affiliation>The Children's Hospital at Westmead, Oncology Unit, Sydney, NSW, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>The Children's Hospital at Westmead, Oncology Unit, Sydney, NSW</wicri:regionArea><wicri:noRegion>NSW</wicri:noRegion></affiliation></author><author><name sortKey="Skinner, R" sort="Skinner, R" uniqKey="Skinner R" first="R" last="Skinner">R. Skinner</name><affiliation wicri:level="1"><nlm:affiliation>Children's BMT Unit, Great North Children's Hospital Royal, Victoria Infirmary, Newcastle upon Tyne, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Children's BMT Unit, Great North Children's Hospital Royal, Victoria Infirmary, Newcastle upon Tyne</wicri:regionArea><wicri:noRegion>Newcastle upon Tyne</wicri:noRegion></affiliation></author><author><name sortKey="O Brien, T A" sort="O Brien, T A" uniqKey="O Brien T" first="T A" last="O'Brien">T A O'Brien</name><affiliation wicri:level="1"><nlm:affiliation>Sydney Children's Hospital, Centre for Children's Cancer, Sydney, NSW, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>Sydney Children's Hospital, Centre for Children's Cancer, Sydney, NSW</wicri:regionArea><wicri:noRegion>NSW</wicri:noRegion></affiliation></author><author><name sortKey="Salooja, N" sort="Salooja, N" uniqKey="Salooja N" first="N" last="Salooja">N. Salooja</name><affiliation wicri:level="3"><nlm:affiliation>Department of Haematology, Hammersmith Hospital, Imperial NHS Trust, London, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Haematology, Hammersmith Hospital, Imperial NHS Trust, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Bader, P" sort="Bader, P" uniqKey="Bader P" first="P" last="Bader">P. Bader</name><affiliation wicri:level="3"><nlm:affiliation>Department of Cell Transplantation and Immunology, Hospital for Children and Adolescents, Frankfurt am Main, Germany.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Cell Transplantation and Immunology, Hospital for Children and Adolescents, Frankfurt am Main</wicri:regionArea><placeName><region type="land" nuts="1">Hesse (Land)</region><region type="district" nuts="2">District de Darmstadt</region><settlement type="city">Francfort-sur-le-Main</settlement></placeName></affiliation></author><author><name sortKey="Peters, C" sort="Peters, C" uniqKey="Peters C" first="C" last="Peters">C. Peters</name><affiliation wicri:level="3"><nlm:affiliation>SCT Unit, St Anna Kinderspital, Medical University, Vienna, Austria.</nlm:affiliation><country xml:lang="fr">Autriche</country><wicri:regionArea>SCT Unit, St Anna Kinderspital, Medical University, Vienna</wicri:regionArea><placeName><settlement type="city">Vienne (Autriche)</settlement><region nuts="2" type="province">Vienne (Autriche)</region></placeName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2016">2016</date><idno type="RBID">pubmed:27348540</idno><idno type="pmid">27348540</idno><idno type="doi">10.1038/bmt.2016.139</idno><idno type="wicri:Area/PubMed/Corpus">001660</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">001660</idno><idno type="wicri:Area/PubMed/Curation">001638</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Curation">001638</idno><idno type="wicri:Area/PubMed/Checkpoint">001638</idno><idno type="wicri:explorRef" wicri:stream="Checkpoint" wicri:step="PubMed">001638</idno><idno type="wicri:Area/Ncbi/Merge">003768</idno><idno type="wicri:Area/Ncbi/Curation">003768</idno><idno type="wicri:Area/Ncbi/Checkpoint">003768</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Incidence and severity of crucial late effects after allogeneic HSCT for malignancy under the age of 3 years: TBI is what really matters.</title><author><name sortKey="Bresters, D" sort="Bresters, D" uniqKey="Bresters D" first="D" last="Bresters">D. Bresters</name><affiliation wicri:level="3"><nlm:affiliation>Willem-Alexander Children's Hospital, LUMC, Leiden, The Netherlands.</nlm:affiliation><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Willem-Alexander Children's Hospital, LUMC, Leiden</wicri:regionArea><placeName><settlement type="city">Leyde</settlement><region nuts="2" type="province">Hollande-Méridionale</region></placeName></affiliation></author><author><name sortKey="Lawitschka, A" sort="Lawitschka, A" uniqKey="Lawitschka A" first="A" last="Lawitschka">A. Lawitschka</name><affiliation wicri:level="3"><nlm:affiliation>SCT Unit, St Anna Kinderspital, Medical University, Vienna, Austria.</nlm:affiliation><country xml:lang="fr">Autriche</country><wicri:regionArea>SCT Unit, St Anna Kinderspital, Medical University, Vienna</wicri:regionArea><placeName><settlement type="city">Vienne (Autriche)</settlement><region nuts="2" type="province">Vienne (Autriche)</region></placeName></affiliation></author><author><name sortKey="Cugno, C" sort="Cugno, C" uniqKey="Cugno C" first="C" last="Cugno">C. Cugno</name><affiliation wicri:level="1"><nlm:affiliation>Pediatric Hematology-Oncology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Pediatric Hematology-Oncology, Fondazione IRCCS Policlinico San Matteo, Pavia</wicri:regionArea><wicri:noRegion>Pavia</wicri:noRegion></affiliation></author><author><name sortKey="Potschger, U" sort="Potschger, U" uniqKey="Potschger U" first="U" last="Pötschger">U. Pötschger</name><affiliation wicri:level="3"><nlm:affiliation>SCT Unit, St Anna Kinderspital, Medical University, Vienna, Austria.</nlm:affiliation><country xml:lang="fr">Autriche</country><wicri:regionArea>SCT Unit, St Anna Kinderspital, Medical University, Vienna</wicri:regionArea><placeName><settlement type="city">Vienne (Autriche)</settlement><region nuts="2" type="province">Vienne (Autriche)</region></placeName></affiliation></author><author><name sortKey="Dalissier, A" sort="Dalissier, A" uniqKey="Dalissier A" first="A" last="Dalissier">A. Dalissier</name><affiliation wicri:level="3"><nlm:affiliation>EBMT Pediatric Diseases Working Party office, Hematology and Cell Therapy Department, Saint-Antoine Teaching Hospital, Paris, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>EBMT Pediatric Diseases Working Party office, Hematology and Cell Therapy Department, Saint-Antoine Teaching Hospital, Paris</wicri:regionArea><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Michel, G" sort="Michel, G" uniqKey="Michel G" first="G" last="Michel">G. Michel</name><affiliation wicri:level="3"><nlm:affiliation>Department of Pediatric Hematology Oncology and Research Unit, Aix-Marseille University and Timone Hospital, Marseille, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Department of Pediatric Hematology Oncology and Research Unit, Aix-Marseille University and Timone Hospital, Marseille</wicri:regionArea><placeName><region type="region">Provence-Alpes-Côte d'Azur</region><region type="old region">Provence-Alpes-Côte d'Azur</region><settlement type="city">Marseille</settlement></placeName></affiliation></author><author><name sortKey="Vettenranta, K" sort="Vettenranta, K" uniqKey="Vettenranta K" first="K" last="Vettenranta">K. Vettenranta</name><affiliation wicri:level="4"><nlm:affiliation>Hospital for Children & Adolescents, University of Helsinki, Helsinki, Finland.</nlm:affiliation><country xml:lang="fr">Finlande</country><wicri:regionArea>Hospital for Children & Adolescents, University of Helsinki, Helsinki</wicri:regionArea><orgName type="university">Université d'Helsinki</orgName><placeName><settlement type="city">Helsinki</settlement><region type="région" nuts="2">Uusimaa</region></placeName></affiliation></author><author><name sortKey="Sundin, M" sort="Sundin, M" uniqKey="Sundin M" first="M" last="Sundin">M. Sundin</name><affiliation wicri:level="3"><nlm:affiliation>Department of Hematology/Immunology/SCT, Astrid Lindgren Children's Hospital, Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden.</nlm:affiliation><country xml:lang="fr">Suède</country><wicri:regionArea>Department of Hematology/Immunology/SCT, Astrid Lindgren Children's Hospital, Karolinska University Hospital and Karolinska Institutet, Stockholm</wicri:regionArea><placeName><settlement type="city">Stockholm</settlement><region nuts="2">Svealand</region></placeName></affiliation></author><author><name sortKey="Al Seraihy, A" sort="Al Seraihy, A" uniqKey="Al Seraihy A" first="A" last="Al-Seraihy">A. Al-Seraihy</name><affiliation wicri:level="1"><nlm:affiliation>Department of Paediatric Haematology/Oncology, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia.</nlm:affiliation><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>Department of Paediatric Haematology/Oncology, King Faisal Specialist Hospital & Research Centre, Riyadh</wicri:regionArea><wicri:noRegion>Riyadh</wicri:noRegion></affiliation></author><author><name sortKey="Faraci, M" sort="Faraci, M" uniqKey="Faraci M" first="M" last="Faraci">M. Faraci</name><affiliation wicri:level="1"><nlm:affiliation>Pediatric Hematology and Oncology HSCT Unit, Instituto G Gaslini, Genova, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Pediatric Hematology and Oncology HSCT Unit, Instituto G Gaslini, Genova</wicri:regionArea><wicri:noRegion>Genova</wicri:noRegion></affiliation></author><author><name sortKey="Sedlacek, P" sort="Sedlacek, P" uniqKey="Sedlacek P" first="P" last="Sedlacek">P. Sedlacek</name><affiliation wicri:level="3"><nlm:affiliation>Department of Paediatric Haematology & Oncology, University Hospital Motol, Prague, Czech Republic.</nlm:affiliation><country xml:lang="fr">République tchèque</country><wicri:regionArea>Department of Paediatric Haematology & Oncology, University Hospital Motol, Prague</wicri:regionArea><placeName><settlement type="city">Prague</settlement><region type="région" nuts="2">Bohême centrale</region></placeName></affiliation></author><author><name sortKey="Versluys, A B" sort="Versluys, A B" uniqKey="Versluys A" first="A B" last="Versluys">A B Versluys</name><affiliation wicri:level="3"><nlm:affiliation>Wilhelmina Children's Hospital, UMCU, Utrecht, The Netherlands.</nlm:affiliation><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Wilhelmina Children's Hospital, UMCU, Utrecht</wicri:regionArea><placeName><settlement type="city">Utrecht</settlement><region nuts="2" type="province">Utrecht (province)</region></placeName></affiliation></author><author><name sortKey="Jenkins, A" sort="Jenkins, A" uniqKey="Jenkins A" first="A" last="Jenkins">A. Jenkins</name><affiliation wicri:level="1"><nlm:affiliation>Department of Pediatric Oncology/Haematology, Sheffield Children's Hospital NHS Foundation Trust, Sheffield, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Pediatric Oncology/Haematology, Sheffield Children's Hospital NHS Foundation Trust, Sheffield</wicri:regionArea><wicri:noRegion>Sheffield</wicri:noRegion></affiliation></author><author><name sortKey="Lutz, P" sort="Lutz, P" uniqKey="Lutz P" first="P" last="Lutz">P. Lutz</name><affiliation wicri:level="3"><nlm:affiliation>Department of Pediatric Hematology Oncology, Nouvel Hopital Civil, Strasbourg, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Department of Pediatric Hematology Oncology, Nouvel Hopital Civil, Strasbourg</wicri:regionArea><placeName><region type="region">Grand Est</region><region type="old region">Alsace (région administrative)</region><settlement type="city">Strasbourg</settlement></placeName></affiliation></author><author><name sortKey="Gibson, B" sort="Gibson, B" uniqKey="Gibson B" first="B" last="Gibson">B. Gibson</name><affiliation wicri:level="1"><nlm:affiliation>Department of Haematology, Royal Hospital for Sick Children, Glasgow, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Haematology, Royal Hospital for Sick Children, Glasgow</wicri:regionArea><wicri:noRegion>Glasgow</wicri:noRegion></affiliation></author><author><name sortKey="Leiper, A" sort="Leiper, A" uniqKey="Leiper A" first="A" last="Leiper">A. Leiper</name><affiliation wicri:level="3"><nlm:affiliation>Department of BMT, Great Ormond Street Hospital for Children Foundation Trust, London, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of BMT, Great Ormond Street Hospital for Children Foundation Trust, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Diaz, M A" sort="Diaz, M A" uniqKey="Diaz M" first="M A" last="Diaz">M A Diaz</name><affiliation wicri:level="3"><nlm:affiliation>Hematopoietic Stem Cell Transplant and Cell Therapy Unit, Children's Hospital Niño Jesus, Madrid, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Hematopoietic Stem Cell Transplant and Cell Therapy Unit, Children's Hospital Niño Jesus, Madrid</wicri:regionArea><placeName><settlement type="city">Madrid</settlement><region nuts="2" type="region">Communauté de Madrid</region></placeName></affiliation></author><author><name sortKey="Shaw, P J" sort="Shaw, P J" uniqKey="Shaw P" first="P J" last="Shaw">P J Shaw</name><affiliation wicri:level="1"><nlm:affiliation>The Children's Hospital at Westmead, Oncology Unit, Sydney, NSW, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>The Children's Hospital at Westmead, Oncology Unit, Sydney, NSW</wicri:regionArea><wicri:noRegion>NSW</wicri:noRegion></affiliation></author><author><name sortKey="Skinner, R" sort="Skinner, R" uniqKey="Skinner R" first="R" last="Skinner">R. Skinner</name><affiliation wicri:level="1"><nlm:affiliation>Children's BMT Unit, Great North Children's Hospital Royal, Victoria Infirmary, Newcastle upon Tyne, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Children's BMT Unit, Great North Children's Hospital Royal, Victoria Infirmary, Newcastle upon Tyne</wicri:regionArea><wicri:noRegion>Newcastle upon Tyne</wicri:noRegion></affiliation></author><author><name sortKey="O Brien, T A" sort="O Brien, T A" uniqKey="O Brien T" first="T A" last="O'Brien">T A O'Brien</name><affiliation wicri:level="1"><nlm:affiliation>Sydney Children's Hospital, Centre for Children's Cancer, Sydney, NSW, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>Sydney Children's Hospital, Centre for Children's Cancer, Sydney, NSW</wicri:regionArea><wicri:noRegion>NSW</wicri:noRegion></affiliation></author><author><name sortKey="Salooja, N" sort="Salooja, N" uniqKey="Salooja N" first="N" last="Salooja">N. Salooja</name><affiliation wicri:level="3"><nlm:affiliation>Department of Haematology, Hammersmith Hospital, Imperial NHS Trust, London, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Haematology, Hammersmith Hospital, Imperial NHS Trust, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Bader, P" sort="Bader, P" uniqKey="Bader P" first="P" last="Bader">P. Bader</name><affiliation wicri:level="3"><nlm:affiliation>Department of Cell Transplantation and Immunology, Hospital for Children and Adolescents, Frankfurt am Main, Germany.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Cell Transplantation and Immunology, Hospital for Children and Adolescents, Frankfurt am Main</wicri:regionArea><placeName><region type="land" nuts="1">Hesse (Land)</region><region type="district" nuts="2">District de Darmstadt</region><settlement type="city">Francfort-sur-le-Main</settlement></placeName></affiliation></author><author><name sortKey="Peters, C" sort="Peters, C" uniqKey="Peters C" first="C" last="Peters">C. Peters</name><affiliation wicri:level="3"><nlm:affiliation>SCT Unit, St Anna Kinderspital, Medical University, Vienna, Austria.</nlm:affiliation><country xml:lang="fr">Autriche</country><wicri:regionArea>SCT Unit, St Anna Kinderspital, Medical University, Vienna</wicri:regionArea><placeName><settlement type="city">Vienne (Autriche)</settlement><region nuts="2" type="province">Vienne (Autriche)</region></placeName></affiliation></author></analytic><series><title level="j">Bone marrow transplantation</title><idno type="eISSN">1476-5365</idno><imprint><date when="2016" type="published">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Younger children are considered to be more vulnerable to late effects (LE), which prompted us to study LE in patients after haematopoietic stem cell transplantation (HSCT) for a haematological malignancy before the age of 3. In this multicentre EBMT study, cumulative incidence (CI) and severity of endocrine LE, central nervous system complications and secondary malignancies at 5, 10, 15 and 20 years of follow-up were assessed. Risk factors (RF) like gender, diagnosis, age at and year of HSCT, TBI- or chemo-conditioning and GVHD were analysed. CI of any LE was 0.30, 0.52, 0.66 and 0.72 at 5, 10, 15 and 20 years after HSCT, respectively. In 25% of the patients, LE were severe at a median follow-up of 10.4 years. In multivariate analysis, only TBI was a RF for having any LE and for thyroid dysfunction and growth disturbance. Female gender was a RF for delayed pubertal development. Some more insight could be gained by descriptive analysis regarding the role of TBI and GVHD on the severity of LE. Although only five selected LE have been studied and median follow-up is relatively short, the incidence and severity of these LE are considerable but not different from what has been found in older children and TBI is the main RF.</div></front></TEI><affiliations><list><country><li>Allemagne</li><li>Arabie saoudite</li><li>Australie</li><li>Autriche</li><li>Espagne</li><li>Finlande</li><li>France</li><li>Italie</li><li>Pays-Bas</li><li>Royaume-Uni</li><li>République tchèque</li><li>Suède</li></country><region><li>Alsace (région administrative)</li><li>Angleterre</li><li>Bohême centrale</li><li>Communauté de Madrid</li><li>District de Darmstadt</li><li>Grand Est</li><li>Grand Londres</li><li>Hesse (Land)</li><li>Hollande-Méridionale</li><li>Provence-Alpes-Côte d'Azur</li><li>Svealand</li><li>Utrecht (province)</li><li>Uusimaa</li><li>Vienne (Autriche)</li><li>Île-de-France</li></region><settlement><li>Francfort-sur-le-Main</li><li>Helsinki</li><li>Leyde</li><li>Londres</li><li>Madrid</li><li>Marseille</li><li>Paris</li><li>Prague</li><li>Stockholm</li><li>Strasbourg</li><li>Utrecht</li><li>Vienne (Autriche)</li></settlement><orgName><li>Université d'Helsinki</li></orgName></list><tree><country name="Pays-Bas"><region name="Hollande-Méridionale"><name sortKey="Bresters, D" sort="Bresters, D" uniqKey="Bresters D" first="D" last="Bresters">D. Bresters</name></region><name sortKey="Versluys, A B" sort="Versluys, A B" uniqKey="Versluys A" first="A B" last="Versluys">A B Versluys</name></country><country name="Autriche"><region name="Vienne (Autriche)"><name sortKey="Lawitschka, A" sort="Lawitschka, A" uniqKey="Lawitschka A" first="A" last="Lawitschka">A. Lawitschka</name></region><name sortKey="Peters, C" sort="Peters, C" uniqKey="Peters C" first="C" last="Peters">C. Peters</name><name sortKey="Potschger, U" sort="Potschger, U" uniqKey="Potschger U" first="U" last="Pötschger">U. Pötschger</name></country><country name="Italie"><noRegion><name sortKey="Cugno, C" sort="Cugno, C" uniqKey="Cugno C" first="C" last="Cugno">C. Cugno</name></noRegion><name sortKey="Faraci, M" sort="Faraci, M" uniqKey="Faraci M" first="M" last="Faraci">M. Faraci</name></country><country name="France"><region name="Île-de-France"><name sortKey="Dalissier, A" sort="Dalissier, A" uniqKey="Dalissier A" first="A" last="Dalissier">A. Dalissier</name></region><name sortKey="Lutz, P" sort="Lutz, P" uniqKey="Lutz P" first="P" last="Lutz">P. Lutz</name><name sortKey="Michel, G" sort="Michel, G" uniqKey="Michel G" first="G" last="Michel">G. Michel</name></country><country name="Finlande"><region name="Uusimaa"><name sortKey="Vettenranta, K" sort="Vettenranta, K" uniqKey="Vettenranta K" first="K" last="Vettenranta">K. Vettenranta</name></region></country><country name="Suède"><region name="Svealand"><name sortKey="Sundin, M" sort="Sundin, M" uniqKey="Sundin M" first="M" last="Sundin">M. Sundin</name></region></country><country name="Arabie saoudite"><noRegion><name sortKey="Al Seraihy, A" sort="Al Seraihy, A" uniqKey="Al Seraihy A" first="A" last="Al-Seraihy">A. Al-Seraihy</name></noRegion></country><country name="République tchèque"><region name="Bohême centrale"><name sortKey="Sedlacek, P" sort="Sedlacek, P" uniqKey="Sedlacek P" first="P" last="Sedlacek">P. Sedlacek</name></region></country><country name="Royaume-Uni"><noRegion><name sortKey="Jenkins, A" sort="Jenkins, A" uniqKey="Jenkins A" first="A" last="Jenkins">A. Jenkins</name></noRegion><name sortKey="Gibson, B" sort="Gibson, B" uniqKey="Gibson B" first="B" last="Gibson">B. Gibson</name><name sortKey="Leiper, A" sort="Leiper, A" uniqKey="Leiper A" first="A" last="Leiper">A. Leiper</name><name sortKey="Salooja, N" sort="Salooja, N" uniqKey="Salooja N" first="N" last="Salooja">N. Salooja</name><name sortKey="Skinner, R" sort="Skinner, R" uniqKey="Skinner R" first="R" last="Skinner">R. Skinner</name></country><country name="Espagne"><region name="Communauté de Madrid"><name sortKey="Diaz, M A" sort="Diaz, M A" uniqKey="Diaz M" first="M A" last="Diaz">M A Diaz</name></region></country><country name="Australie"><noRegion><name sortKey="Shaw, P J" sort="Shaw, P J" uniqKey="Shaw P" first="P J" last="Shaw">P J Shaw</name></noRegion><name sortKey="O Brien, T A" sort="O Brien, T A" uniqKey="O Brien T" first="T A" last="O'Brien">T A O'Brien</name></country><country name="Allemagne"><region name="Hesse (Land)"><name sortKey="Bader, P" sort="Bader, P" uniqKey="Bader P" first="P" last="Bader">P. Bader</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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