Late effects and QOL after stem cell transplantation in childhood

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  • 小児造血幹細胞移植後の晩期合併症とQOL

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 The quality of life (QOL) of pediatric patients that undergo stem cell transplantation (SCT) and the late effects they experience have become more important issues because of improvements in the survival of such patients. The late effects seen in such cases were attributed to 2 major causes: conditioning treatment and chronic graft-versus-host disease (GVHD). More than 40% of the surviving SCT-treated patients were underweight and of short stature, which was twice as high as the equivalent value for the no SCT group. Late effects were observed in 78% of the patients in the SCT group and 45% of those in the no SCT group. Lung toxicity was found to be a common cause of morbidity and mortality after SCT. Many of the children that underwent SCT developed endocrinological dysfunction, including growth hormone and thyroid hormone deficiencies, and gonadal damage and infertility occurred frequently after myeloablative SCT. Persistent secondary immunodeficiency was observed in all of the children with SCT; therefore, post-transplantation re-immunization is indispensable in such patients. The cumulative probability of secondary solid tumors increases after SCT, and the incidence of such tumors is associated with chronic GVHD and radiotherapy. The number of studies examining the QOL of pediatric survivors of SCT is growing. The results of the present study confirm that children that receive SCT should undergo long-term follow-up.

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