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Pediatric Transplants

Late mortality after hematopoietic SCT for a childhood malignancy

Bone Marrow Transplantation volume 48, pages 1291–1295 (2013)Cite this article

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Abstract

Hematopoietic SCT (HSCT) has been used as a curative therapy for pediatric malignancies. Survivors of HSCT are at risk for disease recurrence, late morbidity and mortality. We assessed late mortality (⩾2 years post-HSCT) in a population-based cohort of children who underwent HSCT for a malignancy. Mortality outcomes were determined by linking a clinical transplant database with the Canadian province of Ontario’s pediatric cancer mortality files. Seven hundred and fifty-four children underwent HSCT (371 allogeneic, 383 autologous). Of the 479 (63.5%) who were alive ⩾2 years post HSCT, 98 (20.5%) suffered a late death. Late mortality in the allogeneic HSCT group was 14.9% (median follow-up 10.0 years; range: 2.0–25.6 years), mainly due to relapse of the primary malignancy (64.7%). Chronic GVHD and second malignancies were not major causes of late mortality. A total of 25.5% suffered a late death following autologous HSCT (median follow-up 6.7 years; range: 2.0–22.2 years). Recurrence of the primary malignancy accounted for 87.5% of these deaths. Recurrence of the primary malignancy is the predominant cause of late mortality after HSCT. In contrast to studies of adult patients, non-relapse mortality is less common in children, and death due to chronic GVHD and secondary malignancies is uncommon.

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  1. T Schechter and J D Pole: Drs Schechter and Pole made an equal contribution to the manuscript and are therefore co-first authors.

Authors and Affiliations

  1. Division of Hematology/Oncology, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada

    T Schechter, J D Pole, D Darmawikarta, J Doyle, M Ali, M Egeler, A Gassas, M S Irwin, M Greenberg & P C Nathan

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  1. T Schechter
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Correspondence to T Schechter.

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Schechter, T., Pole, J., Darmawikarta, D. et al. Late mortality after hematopoietic SCT for a childhood malignancy. Bone Marrow Transplant 48, 1291–1295 (2013). https://doi.org/10.1038/bmt.2013.64

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