Incident cancers and late mortality in Australian children treated by allogeneic stem cell transplantation for non‐malignant diseases

• Published in: Pediatric blood & cancer Vol. 64; no. 1; pp. 197 - 202
• Main Authors: Nelson, Adam S., Vajdic, Claire M., Ashton, Lesley J., Marsney, Renate E., Nivison‐Smith, Ian, Wilcox, Leonie, Dodds, Anthony J., O'Brien, Tracey A.
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 01.01.2017
• Subjects: Adolescent; allogeneic stem cell transplantation; Anemia, Aplastic - complications; Anemia, Aplastic - therapy; Australia - epidemiology; Bone Marrow Diseases - complications; Bone Marrow Diseases - therapy; cancer incidence; Child; Child, Preschool; children; Female; Follow-Up Studies; Graft vs Host Disease - epidemiology; Graft vs Host Disease - etiology; Graft vs Host Disease - mortality; Hematology; Hematopoietic Stem Cell Transplantation - adverse effects; Hemoglobinuria, Paroxysmal - complications; Hemoglobinuria, Paroxysmal - therapy; Humans; Incidence; Infant; Infant, Newborn; late mortality; Male; Metabolism, Inborn Errors - complications; Metabolism, Inborn Errors - therapy; Mortality; Neoplasms - epidemiology; Neoplasms - etiology; Neoplasms - mortality; non‐malignant; Oncology; Pediatrics; Population; Prognosis; risk; Risk Factors; Stem cells; Survival Rate; Transplantation, Homologous; X-Linked Combined Immunodeficiency Diseases - complications; X-Linked Combined Immunodeficiency Diseases - therapy; late mortality; risk; allogeneic stem cell transplantation; non-malignant; children; cancer incidence
• ISSN: 1545-5009; 1545-5017
• DOI: 10.1002/pbc.26219

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.