Acute Myeloid Leukemia Survivors at Greater Risk of Long-Term Morbidity After BMT Compared With Healthy Siblings

Survivors of acute myeloid leukemia (AML) who have undergone blood or marrow transplantation (BMT) experience a higher burden of grade 3 or higher chronic health conditions (CHCs) than do their nearest-age siblings. These study results were presented at the 61st American Society of Hematology (ASH) Annual Meeting & Exposition, held in Orlando, Florida.

The focus of this study was on assessing long-term health consequences for survivors of AML who had undergone BMT, based on results of a BMT Survivor Study survey completed by survivors and their nearest-age siblings. A total of 1113 survivors were eligible, of whom 711 were participants, and 1136 nearest-age siblings were selected for comparisons.

For survivors, a mean of 9.7 years had passed between BMT and completion of the survey. Slightly more than half of the survivors (53%) had received conditioning involving fludarabine with melphalan, and most survivors (70.3%) had received stem cells from peripheral blood.

CHCs of grades 3 or 4 were reported for 53.3% of survivors and 30.4% of siblings (odds ratio [OR] 3.0; 95% CI, 2.4-3.7; P <.0001). The 10-year cumulative incidence of CHCs grades 3 to 5 among survivors was 52.0%; the 20-year cumulative incidence was 66.2%.

The study investigators identified several types of CHCs that had significantly higher odds of being reported for survivors compared with siblings. These included subsequent malignant neoplasms (OR 10.0), diabetes (OR 5.3), venous thromboembolism (OR 3.8), cataracts (OR 3.7), and major joint replacement (OR 1.5).

The study results suggest that survivors of AML who underwent BMT are at a heightened risk of multiple severe and/or life-threatening CHCs, and the researchers recommended greater attention to the long-term health of these patients in order to provide appropriate care.

Reference

Armenian SH, Chen Y, Hageman L, et al. Burden of long-term morbidity borne by survivors of acute myeloid leukemia (AML) treated with blood or marrow transplantation (BMT) — a report from the BMT Survivor Study (BMTSS). Oral presentation at: 61st ASH Annual Meeting & Exposition; December 7-10, 2019; Orlando, FL. Abstract 707.