Influence of Metabolic Traits and Lifestyle Factors on Cardiovascular Disease After Hematopoietic Cell Transplantation

Objective: With improvements in hematopoietic cell transplantation (HCT) for severe aplastic anemia (SAA), there is a growing population of SAA survivors of HCT.However, there is a paucity of information regarding late effects in SAA HCT survivors.We analyzed the burden of malignant and non-malignant late effects in HCT survivors with acquired SAA.Methods: A descriptive analysis of 1,718 patients post-HCT for acquired SAA between 1995-2006 reported to the CIBMTR was conducted.Cumulative incidences (CI) of selected late effects are reported for among ''condition-free'' (i.e.survivors without a previous diagnosis of the specified late effect) HCT survivors with SAA.Results: One-year overall survival for the recipients of related donor HCT was 83% (80-85) and 62% (58-66) for the recipients of unrelated donor HCT.Of the HCT recipients, 1176 (68.5%) patients with a median age at HCT of 20 years (\1-65) utilized a related donor and 542 (31.5%) patients with a median age at HCT of 20 years (\1-67) utilized an unrelated donor.The median interval from diagnosis to transplant was 3 months (\1-348) for related donor HCT and 14 months (1-318) for unrelated donor HCT.Radiation (of any type) was utilized in 6% and 78% of related and unrelated donor HCT cases; respectively.Cy-TBI (68%) was a commonly utilized conditioning regimen for unrelated donor HCT.The median follow-up is 70 months (1-160) and 67 months (3-182) for related and unrelated donor HCT; respectively.The 2-year CI of chronic GVHD was 20% (18-22) and 37% (32-41) in related and unrelated donor HCT; respectively.Table 1 demonstrates that among 1-year condition-free survivors, the CI of late effects is greater among unrelated donor HCT survivors and continues to increase.Conclusion: These findings suggest that HCT survviors with SAA are a robust and healthy group in general.However, subgroups of patients undergoing HCT for SAA are at-risk for late effects and must be educated about and should be monitored for late effects.Subgroups of survivors may be at-risk group for a greater burden of spe-cific late effects.Ongoing analyses in our cohort will explore selected risk-factors for late effects after HCT for SAA.