Patient‑Reported Late Effects in Allogeneic Hematopoietic Stem Cell Transplantation Survivorship: A Nationwide Population‑Based Study

Survivorship after allogeneic hematopoietic stem‑cell transplantation is associated with late effects and chronic graft‑versus‑host disease, but population‑level data on patient‑reported outcomes remain limited. To characterize the multidimensional burden of patient-reported late effects in a nationwide cohort of allo-HCT survivors, compare health-related quality of life (HRQOL) with Danish population reference values, and identify symptoms and functional impairments exceeding thresholds for clinical importance (TCI). In this nationwide, population-based cross-sectional study, adult allo-HCT survivors transplanted in Denmark between 1973 and 2024 were identified through transplant databases and registry linkage. Participants completed the European Organisation for Research and Treatment of Cancer Survivorship Questionnaire (QLQ-SURV100). QLQ-C30-equivalent HRQOL scores were compared with age- and sex-stratified Danish population reference values, and TCI were applied. Of 1333 eligible survivors, 895 participated (67%). Median age was 64 yr (range, 21 to 84), and median time since transplantation was 7 yr (range, 0 to 44). Participants reported a mean of 18 concurrent symptoms, including 8 of moderate-to-high severity; only 1% reported none. Negative health outlook (93%) and fatigue (90%) were the most prevalent late effects. Overall, 91% reported low or moderate sexual functioning, and sexual problems showed the highest severity. Among participants aged ≤67 yr, 45% were not working, and loss of income was reported by 54% overall. Participants reported poorer HRQOL than population reference values, and 38% exceeded TCI in at least 5 domains. Allo-HCT survivorship is characterized by multiple concurrent symptoms and impairments, demonstrating a substantial population-level burden with implications for long-term survivorship care.