Transplant characteristics and self-reported pulmonary outcomes in Swiss childhood cancer survivors after hematopoietic stem cell transplantation-a cohort study

Maria Otth, Christina Schindera, Tayfun Güngör, Marc Ansari, Katrin Scheinemann, Fabiën N Belle, Philipp Latzin, Nicolas von der Weid, Claudia E Kuehni, Swiss Pediatric Oncology Group (SPOG), M Ansari, M Beck Popovic, J P Bourquin, P Brazzola, J Greiner, J Rössler, F Schilling, K Scheinemann, N von der Weid, Maria Otth, Christina Schindera, Tayfun Güngör, Marc Ansari, Katrin Scheinemann, Fabiën N Belle, Philipp Latzin, Nicolas von der Weid, Claudia E Kuehni, Swiss Pediatric Oncology Group (SPOG), M Ansari, M Beck Popovic, J P Bourquin, P Brazzola, J Greiner, J Rössler, F Schilling, K Scheinemann, N von der Weid

Abstract

Childhood cancer survivors treated with hematopoietic stem cell transplantation are at high risk for pulmonary morbidity and mortality. In this retrospective study we described transplant characteristics of pediatric patients who underwent hematopoietic stem cell transplantation in Switzerland and how these characteristics changed over time, compared self-reported pulmonary outcomes between transplanted and non-transplanted survivors, and investigated risk factors for the reported pulmonary outcomes. As part of the population-based Swiss Childhood Cancer Survivor Study, we sent questionnaires to all ≥5-year childhood cancer survivors diagnosed 1976-2010 at age ≤20 years. We included 132 transplanted survivors and 368 matched non-transplanted survivors. During the study period transplant characteristics changed, with decreasing use of total body irradiation and increased use of peripheral blood stem cells and mismatched and unrelated donors as transplant source. One-fifth of transplanted survivors (20%, 95%CI 13-27%) and 18% of non-transplanted survivors (95%CI 13-21%) reported at least one pulmonary outcome. None of the analyzed factors was significantly associated with an increased risk of pulmonary outcomes in multivariable analysis. We found that pulmonary outcomes were frequently reported in transplanted and non-transplanted childhood cancer survivors, indicating a strong need for long-term pulmonary follow-up care.

Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1. Prevalence of self-reported pulmonary diseases…
Fig. 1. Prevalence of self-reported pulmonary diseases and symptoms in transplanted (N = 132) and non-transplanted matched childhood cancer survivors (N = 368).
Error bars represent 95% confidence intervals. P value comparing prevalence between transplanted and non-transplanted survivors. *Total N reduced for pulmonary fibrosis and emphysema because question only asked in adolescents and adults: N = 85 transplanted survivors, N = 195 non-transplanted survivors. ** “Other pulmonary outcome” includes reduced lung function (n = 3) and pulmonary GvHD (n = 1).

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