Late effects after allogeneic hematopoietic cell transplantation with busulphan conditioning in 33 childhood leukemia survivors (1987-2013)

Late effects (LE) after busulphan (BU) conditioning Hematopoietic Cell Transplantation (HCT) in childhood leukemia survivors are rarely studied.LE were retrospectively collected for 33 childhood leukemia survivors (median age 21y at follow-up) treated with BU myeloablative conditioning allogeneic HCT.Median delay after HCT was 14.0y and median age at evaluation was 21.0y (17.0-33.5).Patients had a chronic Graft versus Host Disease (cGvHD) (n=3).The mean number of severe late effects was 1.1 per patient: decreased height at adulthood (n=4); Growth Hormone deficit (n=1); risk of impaired fertility (n=14/18 females; n=7/15 males; 2 women had a child); iron overload (n=3); mellitus diabetes (n=1); pulmonary LE (n=2); psychiatric disorders (n=3); sclerodermic cGvHD (n=1); severe academic difficulties (n=3).On the contrary, we found no cardiac, renal or CNS LE, and no secondary cancer.Among the other non-severe LE, there was: alopecia (n=3); treated hypogonadism (n=13 -all females); low weight (n=10); minor overweight (n=13); hepatic focal nodular hyperplasia (n=9); dental hypoplasia (n=6); osteopenia (n=4); hypertriglyceridemia (n=4); moderate cataract (n=1).Conclusion: The mean number of severe late effects was 1.1 (±1.0) per patient, significantly less than in our other cohort of 71 children grafted after TBI conditioning published in 2019 (2.3 ±1.5; p<0.0001).