Late Effects of HSCT

Chapter 133 Late Effects of HSCT



Andrea Velardi, Franco Locatelli



Many children who receive hematopoietic stem cell transplantation (HSCT) become long-term survivors. Besides chronic graft versus host disease (GVHD), long-term complications include impaired growth, neuroendocrine dysfunction, delayed puberty, infertility, second malignancies, cataracts and other ocular complications, leukoencephalopathy, and cardiac and pulmonary dysfunction (see Table 133-1 on the Nelson Textbook of Pediatrics website atimage www.expertconsult.com).




Table 133-1 LATE EVENTS


Osteopenia

Hypothyroidism

Pulmonary complications
DLCO <80% predicted

TLC < 80% predicted

FEV1/FVC < 85% predicted

Cataracts

Hypogonadism

Chronic GVHD

Growth hormone deficiency

Chronic renal insufficiency

Academic difficulty

Osteonecrosis

Hypertension

Chronic sinusitis

Seizure disorder

ACTH deficiency

Excessive dental caries (>4)

Leukoencephalopathy

Depression

Disease relapse

Abnormal electrocardiogram

Abnormal echocardiogram

Microscopic hematuria

Precocious puberty

Ototoxicity

Secondary malignancy

DLCO, carbon monoxide diffusing capacity; FEV, forced expiratory volume; FVC, forced vital capacity; GVHD, graft versus host disease; TLC, total lung capacity.

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Jun 18, 2016 | Posted by in PEDIATRICS | Comments Off on Late Effects of HSCT

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