LONG-TERM EFFECTS OF ALLOGENEIC HEMATOPOIETIC STEM CELL TRANSPLANTATION AMONG SURVIVORS AT UNIVERSITY HOSPITAL CENTRE ZAGREB
Antonela Samardžić, Zinaida Perić, Ranka Serventi-Seiwerth, Lana Desnica, Radovan Vrhovac, Nadira Duraković
The number of long-term survivors after allogeneic hematopoietic stem cell transplantation is increasing daily, and late effects of such treatment cause significant quality of life impairment. We analysed the data of 111 long-term survivors that were transplanted at the University Hospital Centre Zagreb in the period between 1986 and 2009. For the investigated population survival median time was 15 years (range 2–33). Our results were similar to those reported by other researchers, and have shown a rising trend over a longer follow-up period. The cumulative incidence of cardiovascular and endocrine complications, solid tumors, chronic graft versus host disease (GvHD), liver, renal and pulmonary diseases is 64%, 42%, 33%, 32%, 28%, 17% and 14%, respectively. Further analysis confirmed that the spontaneous recovery of menstrual cycle was more likely among patiens transplanted in childhood than in adulthood (45% vs 18%). Premature ovarian insufficiency (POI) was detected in 71% of female patients transplanted in adult age. However, five women gave birth to six healthy children in this study population, where two pregnancies occurred after spontaneous recovery of ovarian function, one after the use of hormone replacement therapy (HRT) for POI, and other three occurred after assisted reproductive treatment. The results obtained can be used as a guideline for prevention and early detection of late effects with the purpose of enabling better life for long-term survivors of HSCT in the Republic of Croatia.
Antonela Samardžić, Lana Desnica, Nadira Duraković, Radovan Vrhovac, Ranka Serventi-Seiwerth, Zinaida Perić