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- Title
Incidence and risk factors for cataract after haematopoietic stem cell transplantation for childhood leukaemia: an LEA study.
- Authors
Horwitz, Meryl; Auquier, Pascal; Barlogis, Vincent; Contet, Audrey; Poiree, Maryline; Kanold, Justyna; Bertrand, Yves; Plantaz, Dominique; Galambrun, Claire; Berbis, Julie; Villes, Virginie; Chastagner, Pascal; Sirvent, Nicolas; Oudin, Claire; Michel, Gérard
- Abstract
Cataract was prospectively assessed by serial slip lamp tests in 271 patients included in the Leucémie Enfants Adolescents ( LEA) programme, the French cohort of childhood leukaemia survivors. All had received haematopoietic stem cell transplantation ( HSCT) after total body irradiation ( TBI, n = 201) or busulfan-based ( n = 70) myeloablative conditioning regimen. TBI was fractionated in all but six patients. The mean duration of follow-up from HSCT was 10·3 years. Cataract was observed in 113/271 patients (41·7%); 9/113 (8·1%) needed surgery. Cumulative incidence after TBI increased over time from 30% at 5 years to 70·8% and 78% at 15 and 20 years, respectively, without any plateau thereafter. The 15-year cumulative incidence was 12·5% in the Busulfan group. A higher cumulative steroid dose appeared to be a cofactor of TBI for cataract risk, in both univariate and multivariate Cox analysis. In the multivariate analysis, cataract had an impact in two quality of life domains: 'the role limitation due to physical problems' and 'the role limitation due to emotional problems'. These data suggest that with increasing follow-up, nearly all patients who receive TBI, even when fractionated, will suffer from cataract that can impact on their quality of life and that high cumulative steroid dose is a cofactor.
- Subjects
CATARACT; HEMATOPOIETIC stem cell transplantation; LEUKEMIA in children; TOTAL body irradiation; MULTIVARIATE analysis; BUSULFAN; DISEASE risk factors
- Publication
British Journal of Haematology, 2015, Vol 168, Issue 4, p518
- ISSN
0007-1048
- Publication type
Article
- DOI
10.1111/bjh.13148