Late complications after hematopoietic stem cell transplantation

Expert Rev Hematol. 2009 Oct;2(5):583-601. doi: 10.1586/ehm.09.48.

Abstract

Hematopoietic stem cell transplantation (HSCT) offers the opportunity for cure to patients with leukemia, lymphoma and severe non-malignant diseases. More than 40,000 HSCTs are performed annually worldwide. Therefore, the number of long-term survivors, free of the disease for which they were transplanted is continuously increasing. Despite the improved prognosis of HSCT, long-term outcome may be impaired by transplant-associated morbidity and mortality. Long-term survivors can present a variety of malignant and non-malignant complications, impairing physical and psychological performance, normal integration in family and social life, and quality of life. Conditioning regimens, particularly when including total-body irradiation as well as graft-versus-host disease, play a key role in the development of late effects. However, with increasing time since transplantation new types of late effects may emerge. Awareness on long-term effects after HSCT is crucial to provide adapted pretransplant counseling, and recommendations for post-transplant screening, prevention and early treatment.

Publication types

  • Review

MeSH terms

  • Bone Diseases / etiology
  • Bone Diseases / prevention & control
  • Bronchiolitis Obliterans / etiology
  • Bronchiolitis Obliterans / prevention & control
  • Cardiovascular Diseases / etiology
  • Cardiovascular Diseases / prevention & control
  • Central Nervous System Diseases / etiology
  • Central Nervous System Diseases / prevention & control
  • Endocrine System Diseases / etiology
  • Endocrine System Diseases / prevention & control
  • Gonadal Disorders / etiology
  • Gonadal Disorders / prevention & control
  • Graft vs Host Disease / etiology
  • Graft vs Host Disease / prevention & control
  • Hematopoietic Stem Cell Transplantation / adverse effects*
  • Humans
  • Kidney Diseases / etiology
  • Kidney Diseases / prevention & control
  • Liver Diseases / diagnosis
  • Liver Diseases / prevention & control
  • Neoplasms / etiology
  • Neoplasms / prevention & control