Health and functional status of adult recipients 1 year after allogeneic haematopoietic stem cell transplantation

Increasing numbers of patients are surviving after allogeneic haematopoieti c stem cell transplantation (SCT). Among these patients, a number of late c omplications have been described but few data on the risk factors of these long-term effects of SCT are available. We report the analysis on 105 adult patients, surviving free of haematological disease at a median time of 15 months after SCT. At the time of screening, 52% had returned to work, gener al health status was normal in 67% and 47% were sexually active. Female pat ient gender odds ratio (OR) 2.9 (P = 0.01) and age >25 years (OR = 3.2. P = 0.02) were associated with non-return to work. Decreased general status wa s associated with chronic graft-versus-host disease (GvHD) (OR = 3.2, P = 0 .009) and irradiation (OR = 3.6, P = 0.004). Sexual inactivity was associat ed with younger age (OR = 7.0, P = 0.0002) and chronic GVHD (OR = 3.3. P = 0.006). Risk factors for altered pulmonary function tests included previous smoking habits, irradiation and chronic GvHD. Obstructive lung disease was associated with a previous history of asthma. Sicca syndrome and conjuncti vitis were increased in patients with previous acute GVHD and cataracts wer e less frequent in patients with aplastic anaemia. Persistent impaired hair re-growth was less frequent in patients who received irradiation (OR = 0.1 8. P = 0.002) but increased in patients with previous acute GVHD (OR = 5.3, P = 0.007), Microalbuminuria was more frequent in irradiated patients (OR = 9.4, P = 0.05). Raised cholesterol was associated with age (OR = 20.8. P < 0.001), previous acute GVHD (OR = 4.7, P = 0.03), steroid use (OR = 6.3, P = 0.001) and familial hypercholesterolaemia (OR = 4.4, P = 0.04). Decreas ed bone density was associated with chronic GVHD (OR = 3.9. P = 0.001). Thu s, using routine tests in adult patients we were able to detect significant numbers of non-symptomatic complications enabling early treatment.