1. ¹Pediatric Haematology and Public Health Departments, Centre Hospitalo-Université de Marseille, Marseille, France
2. ²Pediatric Haematology Department, Centre Hospitalo-Université de Nancy, Nancy, France

Correspondence: Professor G Michel, Service de Pédiatrie et Hématologie Pédiatrique, Hôpital d'Enfants La Timone, Rue St Pierre, Marseille 13385, France. E-mail: gmichel@ap-hm.fr

Received 11 May 2007; Revised 28 June 2007; Accepted 9 July 2007; Published online 20 August 2007.

Abstract

We compared late side effects and quality of life (QoL) in 430 survivors of childhood acute leukaemia based on whether they had undergone haematopoietic cell transplantation (n=142) or not (n=288). Mean age was 18.2 years and mean follow-up duration was 11.9 years. Multivariate logistic regression analyses were performed to compare the risk of each type of late effect in the two groups. Based on age, VSP-A or SF36 questionnaires were used to assess QoL. For each QoL dimension, multiple linear regression was done to construct models of association with the treatment group. Transplanted patients experienced more side effects, including height growth failure, gonadal dysfunction, hypothyroidism and cataract. Children and adolescents in the two treatment groups reported similar QoL levels for almost all dimensions except a better perception of school work by young transplanted children and more difficulties in relating to the medical staff for transplanted adolescents. In adults, two differences in physical domain of QoL were detected but the calculated effect sizes were less than 0.2 in each case, suggesting an uncertain clinical significance. In spite of a higher risk of physical adverse events in the transplanted group, very few clinically significant differences in QoL are detectable.