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Incident cancers and late mortality in Australian children treated by allogeneic stem cell transplantation for non‐malignant diseases
Author(s) -
Nelson Adam S.,
Vajdic Claire M.,
Ashton Lesley J.,
Marsney Renate E.,
NivisonSmith Ian,
Wilcox Leonie,
Dodds Anthony J.,
O'Brien Tracey A.
Publication year - 2017
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.26219
Subject(s) - medicine , hematopoietic stem cell transplantation , standardized mortality ratio , population , cohort , survivorship curve , pediatrics , transplantation , cancer , disease , environmental health
Background Hematopoietic stem cell transplantation (HSCT) is a life‐saving procedure for children with a variety of non‐malignant conditions. However, these children face an increased risk of late death and incident cancers after HSCT, which may occur many years after their initial HSCT. Procedure We examined cancer occurrence and late mortality in a population‐based cohort of 318 Australian children who underwent allogeneic HSCT for non‐malignant disease. Standardized incident ratios (SIRs) and standardized mortality ratios (SMRs) were calculated and compared with population controls. Results We identified six (1.9%) cancers at a median 9.2 years post‐HSCT. Cancer occurred 15 times more frequently than in the general population (SIR 15.4, 95% CI = 6.9–34.2). Of the 198 patients who survived for at least 2 years post‐HSCT, 11 (5.6%) died at a median 7.5 years post‐HSCT. The mortality rate was 17 times higher than in the general population (SMR 17.5, 95% CI = 9.7–31.2). Discussion Children transplanted for non‐malignant conditions require evidence‐based survivorship programs to reduce excess morbidity and mortality.