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CHAPTER 8 Long‐term follow‐up of children
Paul A. Carpenter
Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
Introduction
More than half a million HCT survivors are estimated by 2030 due to improvements in HLA‐typing and supportive care [1]. Unfortunately, among HCT‐recipients who survive at 2 years without recurrence of their original disease indication for transplant, there is a four‐ to nine‐fold increased mortality rate for 5‐year survivors relative to an age and sex‐matched general population [2–5].
This can be attributed to an increased cumulative incidence (CI) of chronic health conditions among HCT survivors; in one study 66% had at least one chronic health condition and the 10‐year CI for severe/life‐threatening conditions or death as result was 35% (95%CI, 32–39%). HCT survivors were 3.5 times as likely as siblings to develop a severe/life‐threatening condition, this was amplified further among those survivors with chronic graft‐versus‐host‐disease (cGVHD) [6].
All HCT late effects result from varying degree of interaction between underlying diagnosis, pre‐HCT exposures to chemotherapy and radiation, and post‐HCT complications including GVHD, immunodeficiency
