The Impact of Donor Type on Long-Term Health Status and Quality of Life after Allogeneic Hematopoietic Stem Cell Transplantation for Childhood Acute Leukemia: A Leucemie de l'Enfant et de L'Adolescent Study

Sandrine Visentin (1) , Pascal Auquier (2) , Yves Bertrand (3) , André Baruchel (4) , Marie-Dominique Tabone (5) , Cécile Pochon (6) , Charlotte Jubert (7) , Maryline Poiree (8) , Virginie Gandemer (9, 10) , Anne Sirvent (11) , Jacinthe Bonneau (12, 10) , Catherine Paillard (13) , Claire Freycon , Justyna Kanold (14) , Virginie Villes (2) , Julie Berbis (2) , Claire Oudin (15, 2) , Claire Galambrun (16) , Isabelle Pellier (17) , Genevieve Plat (18) , Hervé Chambost (16) , Guy Leverger (5) , Jean-Hugues Dalle (19) , Gérard Michel (20)

1 Service de pédiatrie multidisciplinaire [Hôpital de la Timone Enfants - APHM]
2 SPMC - Santé Publique et maladies Chroniques : Qualité de vie Concepts, Usages et Limites, Déterminants
3 Hématologie et immunologie pédiatrique
4 Service d'hématologie et immunologie pédiatrique
5 Service d'hématologie-immunologie-oncologie pédiatrique [CHU Trousseau]
6 MaMEA Nancy-Brabois - Centre de référence des maladies héréditaires du métabolisme
7 Groupe hospitalier Pellegrin
8 Service de Pédiatrie, Unité d'Oncologie et Hématologie Pédiatrique
9 IGDR - Institut de Génétique et Développement de Rennes
10 CHU Pontchaillou [Rennes]
11 CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]
12 Hématogoie pédiatrique
13 Service d'oncologie médicale [CHU Strasbourg]
14 Service d'hématologie pédiatrique
15 Service d'hématologie pédiatrique
16 Service d'Hématologie pédiatrique, Hôpital de la Timone, Marseille
17 CHU Angers - Centre Hospitalier Universitaire d'Angers
18 CHU Toulouse - Centre Hospitalier Universitaire de Toulouse
19 Hôpital Robert Debré Paris
20 Pédiatrie et oncologie pédiatrique [Hôpital de la Timone - APHM]

We compared the long-term impact of donor type (sibling donor [SD] versus matched unrelated donor [MUD] or umbilical cord blood [UCB]) on late side effects and quality of life (QoL) in childhood acute leukemia survivors treated with hematopoietic stem cell transplantation. We included 314 patients who underwent transplantation from 1997 to 2012 and were enrolled in the multicenter French Leucemie de l'Enfant et de L'Adolescent ("Leukemia in Children and Adolescents") cohort. More than one-third of the patients were adults at last visit; mean follow-up duration was 6.2 years. At least 1 late effect was observed in 284 of 314 patients (90.4%). The average number of adverse late effects was 2.1 +/- 1, 2.4 +/- 2, and 2.4 +/- 2 after SD, MUD, and UCB transplantation, respectively. In a multivariate analysis, considering the SD group as the reference, we did not detect an impact of donor type for most sequelae, with the exception of increased risk of major growth failure after MUD transplantation (odds ratio [OR], 2.42) and elevated risk of osteonecrosis after UCB transplantation (OR, 4.15). The adults and children's parents reported comparable QoL among the 3 groups. Adult patient QoL scores were lower than age- and sex-matched French reference scores for almost all dimensions. We conclude that although these patients are heavily burdened by long-term complications, donor type had a very limited impact on their long-term health status and QoL.

Keywords: Quality of life; Late effects; Hematopoietic stem cell transplantation; Cord blood transplantation; Childhood leukemia

Domains: Life Sciences [q-bio]; Cancer; Life Sciences [q-bio]; Human health and pathology; Hematology; Life Sciences [q-bio]; Human health and pathology; Pediatrics

Sandrine Visentin, Pascal Auquier, Yves Bertrand, André Baruchel, Marie-Dominique Tabone, et al.. The Impact of Donor Type on Long-Term Health Status and Quality of Life after Allogeneic Hematopoietic Stem Cell Transplantation for Childhood Acute Leukemia: A Leucemie de l'Enfant et de L'Adolescent Study. Biology of Blood and Marrow Transplantation, 2016, 22 (11), pp.2003--2010. ⟨10.1016/j.bbmt.2016.08.004⟩. ⟨hal-01415935⟩