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Pinelli V, Christophe L, Cheron N, Morin S, Gilis L, Heuze C, Clerc-Renaud D, Morotti L, Vilhet B, Bissardon S, Magro L. [Pre-, per- and post-allogeneic haematopoietic stem cell transplant rehabilitation (Atelier SFGM-TC)]. Bull Cancer 2024:S0007-4551(24)00217-0. [PMID: 38981828 DOI: 10.1016/j.bulcan.2024.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 04/29/2024] [Accepted: 05/05/2024] [Indexed: 07/11/2024]
Abstract
Allogeneic transplantation of haematopoietic stem cells is still the only curative treatment for certain haematological malignancies. This treatment can be responsible for a number of side-effects, leading to multiple and interdependent physical and psychological deficiencies that affect patients' quality of life and social participation, and can be experienced as a handicap, sometimes for several years after the transplant. For several years now, the integration of post-transplant rehabilitation pathways has been becoming more widespread, and initiatives to provide multidisciplinary care at an increasingly early stage are being studied. The aim of this early management is to improve the patient's overall functional state before, during and after the transplant, in order to limit the impact of the treatment and ensure the quickest possible return to a life that is as satisfying as possible. The international literature and the experiments carried out throughout the French-speaking world describe heterogeneous practices. Based on this literature and experience, the aim of this study is to issue homogenous recommendations for good clinical practice and to identify areas for further research into pre-transplant, per-transplant and post-transplant rehabilitation of haematopoietic stem cells.
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Affiliation(s)
- Virgile Pinelli
- Clinique de l'Union, unité de préhabilitation et oncoréhabilitation, boulevard Ratalens, 31240 Saint-Jean, France.
| | - Laure Christophe
- Service d'oncoréhabilitation, hôpital Henry-Gabrielle, Saint-Genis-Laval, hospices civils de Lyon, Lyon, France
| | - Nathalie Cheron
- Centre hospitalier de Bligny, service hématologie soins de suite, rue de Bligny 91640 Briis-sous-Forges, France
| | - Sarah Morin
- Hopital universitaire de Genève, service d'hématologie, rue Gabrielle-Perret-Gentil 4, 1211 Genève 14, Suisse
| | - Lila Gilis
- Service d'oncoréhabilitation, hôpital Henry-Gabrielle, Saint-Genis-Laval, hospices civils de Lyon, Lyon, France
| | - Candy Heuze
- Service d'hématologie, CHU de Rouen, 37, boulevard Gambetta, 76000 Rouen, France
| | - Dominique Clerc-Renaud
- Hopital universitaire de Genève, service d'hématologie, rue Gabrielle-Perret-Gentil 4, 1211 Genève 14, Suisse
| | - Laurence Morotti
- CHU Saint-Eloi, pôle des cliniques médicales, 80, avenue Augustin-Fliche, 34090 Montpellier, France
| | - Benoit Vilhet
- CHU Saint-Eloi, pôle des cliniques médicales, 80, avenue Augustin-Fliche, 34090 Montpellier, France
| | - Sandra Bissardon
- Institut de cancérologie et d'hématologie universitaire de Saint-Étienne, 108 bis, avenue Albert-Raimond, 42270 Saint-Priest-en-Jarez, France
| | - Leonardo Magro
- CHRU de Lille, service des maladies du sang, 2, avenue Oscar-Lambret, 59037 Lille cedex, France
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Caru M, Dubois P, Curnier D, Andelfinger G, Krajinovic M, Laverdière C, Sinnett D, Périé D. Echocardiographic Parameters Associated With Cardiorespiratory Fitness and Physical Activity in Childhood Acute Lymphoblastic Leukemia Survivors. J Phys Act Health 2023; 20:1152-1161. [PMID: 37793652 DOI: 10.1123/jpah.2023-0100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 06/30/2023] [Accepted: 08/15/2023] [Indexed: 10/06/2023]
Abstract
BACKGROUND Children's exposure to chemotherapeutic agents causes several long-term adverse effects but physical activity has been evidenced to be an effective strategy to improve cardiac function. This cross-sectional study aimed to explore the association between physical activity levels, cardiorespiratory fitness, and cardiac parameters measured by echocardiography. METHODS Participants were 216n childhood acute lymphoblastic leukemia survivors who underwent a maximal cardiopulmonary exercise test and self-reported their daily minutes of moderate to vigorous physical activity. They underwent a complete transthoracic echocardiographic assessment. Systolic and diastolic function analysis and strain images analysis were performed. The associations were studied through the preventive fraction (examined with univariate crude and adjusted logistic regression models) of regular physical activity (≥150 min·wk-1) and adequate cardiorespiratory fitness levels (above the median ≥ 32.0 mL·kg-1·min-1) on cardiac parameters. RESULTS Crude analysis shows that regular physical activity was associated with a significant preventive fraction in mitral E/A ratio (56%; P = .013), while adjusted analyses highlighted a nonsignificant reduction of 74% to 37% in the prevalence of cardiac parameters associated with physical activity. Similar associations of adequate cardiorespiratory fitness on cardiac parameters were observed. Adjusted analyses revealed a nonsignificant reduction of 7% to 86% in the prevalence of cardiac parameters associated with cardiorespiratory fitness. CONCLUSION This study reports that regular physical activity and adequate cardiorespiratory fitness were associated with a higher preventive fraction. Thus, engaging in physical activity prevents childhood acute lymphoblastic leukemia survivors' cardiac dysfunctions. These findings are novel and clinically relevant in pediatric cardiooncology and provide additional evidence to strengthen the benefits of exercise as long-term care in childhood cancer survivors.
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Affiliation(s)
- Maxime Caru
- Laboratory of Pathophysiology of EXercise (LPEX), School of Kinesiology and Physical Activity Sciences, Faculty of Medicine, University of Montreal, Montreal, QC, Canada
- Research Center, Sainte-Justine University Health Center, Montreal, QC, Canada
- Department of Mechanical Engineering, Polytechnique Montreal, Montreal, QC, Canada
| | - Pierre Dubois
- Department of Mechanical Engineering, Polytechnique Montreal, Montreal, QC, Canada
| | - Daniel Curnier
- Laboratory of Pathophysiology of EXercise (LPEX), School of Kinesiology and Physical Activity Sciences, Faculty of Medicine, University of Montreal, Montreal, QC, Canada
- Research Center, Sainte-Justine University Health Center, Montreal, QC, Canada
| | - Gregor Andelfinger
- Research Center, Sainte-Justine University Health Center, Montreal, QC, Canada
- Department of Pediatrics, University of Montreal, Montreal, QC, Canada
| | - Maja Krajinovic
- Research Center, Sainte-Justine University Health Center, Montreal, QC, Canada
- Department of Pediatrics, University of Montreal, Montreal, QC, Canada
| | - Caroline Laverdière
- Research Center, Sainte-Justine University Health Center, Montreal, QC, Canada
- Department of Pediatrics, University of Montreal, Montreal, QC, Canada
| | - Daniel Sinnett
- Research Center, Sainte-Justine University Health Center, Montreal, QC, Canada
- Department of Pediatrics, University of Montreal, Montreal, QC, Canada
| | - Delphine Périé
- Research Center, Sainte-Justine University Health Center, Montreal, QC, Canada
- Department of Mechanical Engineering, Polytechnique Montreal, Montreal, QC, Canada
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Artese AL, Winthrop HM, Bohannon L, Lew MV, Johnson E, MacDonald G, Ren Y, Pastva AM, Hall KS, Wischmeyer PE, Macleod D, Molinger J, Barth S, Jung SH, Cohen HJ, Bartlett DB, Sung AD. A pilot study to assess the feasibility of a remotely monitored high-intensity interval training program prior to allogeneic hematopoietic stem cell transplantation. PLoS One 2023; 18:e0293171. [PMID: 38032994 PMCID: PMC10688680 DOI: 10.1371/journal.pone.0293171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 10/05/2023] [Indexed: 12/02/2023] Open
Abstract
INTRODUCTION Although allogeneic hematopoietic stem cell transplantation (HCT) can be a curative therapy for hematologic disorders, it is associated with treatment-related complications and losses in cardiorespiratory fitness and physical function. High-intensity interval training (HIIT) may be a practical way to rapidly improve cardiorespiratory fitness and physical function in the weeks prior to HCT. The primary aim of this study was to assess the feasibility of implementing a pre-HCT home-based HIIT intervention. The secondary aim was to evaluate pre to post changes in cardiorespiratory fitness and physical function following the intervention. METHODS This was a single-arm pilot study with patients who were scheduled to undergo allogeneic HCT within six months. Patients were instructed to complete three 30-minute home-based HIIT sessions/week between the time of study enrollment and sign-off for HCT. Sessions consisted of a 5-minute warm-up, 10 high and low intervals performed for one minute each, and a 5-minute cool-down. Prescribed target heart rates (HR) for the high- and low-intensity intervals were 80-90% and 50-60% of HR reserve, respectively. Heart rates during HIIT were captured via an Apple Watch and were remotely monitored. Feasibility was assessed via retention, session adherence, and adherence to prescribed interval number and intensities. Paired t-tests were used to compare changes in fitness (VO2peak) and physical function [Short Physical Performance Battery (SPPB), 30-second sit to stand, and six-minute walk test (6MWT)] between baseline and sign-off. Pearson correlations were used to determine the relationship between intervention length and changes in cardiorespiratory fitness or functional measures. RESULTS Thirteen patients (58.8±11.6 years) participated in the study, and nine (69.2%) recorded their training sessions throughout the study. Median session adherence for those nine participants was 100% (IQR: 87-107). Adherence to intervals was 92% and participants met or exceeded prescribed high-intensity HR on 68.8±34.8% of intervals. VO2peak improved from baseline to sign-off (14.6±3.1 mL/kg/min to 17.9±3.3 mL/kg/min; p<0.001). 30-second sit to stand and SPPB chair stand scores significantly improved in adherent participants. Improvements in 30-second sit to stand (13.8±1.5 to 18.3±3.3 seconds) and 6MWT (514.4±43.2 to 564.6±19.3) exceeded minimal clinically important improvements established in other chronic disease populations, representing the minimum improvement considered meaningful to patients. CONCLUSIONS Findings demonstrate that implementing a pre-HCT home-based remotely monitored HIIT program is feasible and may provide benefits to cardiorespiratory fitness and physical function.
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Affiliation(s)
- Ashley L. Artese
- Center for the Study of Aging and Human Development, Duke University Medical Center, Durham, North Carolina, United States of America
- Department of Exercise Science and Health Promotion, Florida Atlantic University, Boca Raton, Florida, United States of America
| | - Hilary M. Winthrop
- Division of Hematologic Malignancies and Cellular Therapy, Department of Medicine, Duke University Medical Center, Durham, North Carolina, United States of America
| | - Lauren Bohannon
- Division of Hematologic Malignancies and Cellular Therapy, Department of Medicine, Duke University Medical Center, Durham, North Carolina, United States of America
| | - Meagan V. Lew
- Division of Hematologic Malignancies and Cellular Therapy, Department of Medicine, Duke University Medical Center, Durham, North Carolina, United States of America
| | - Ernaya Johnson
- Division of Hematologic Malignancies and Cellular Therapy, Department of Medicine, Duke University Medical Center, Durham, North Carolina, United States of America
| | - Grace MacDonald
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, North Carolina, United States of America
- Division of Medical Oncology, Duke University School of Medicine, Durham, North Carolina, United States of America
| | - Yi Ren
- Duke Cancer Institute Biostatistics Shared Resources, Duke University School of Medicine, Durham, North Carolina, United States of America
| | - Amy M. Pastva
- Center for the Study of Aging and Human Development, Duke University Medical Center, Durham, North Carolina, United States of America
- Department of Orthopaedic Surgery, Physical Therapy Division, Duke University School of Medicine, Durham, North Carolina, United States of America
| | - Katherine S. Hall
- Center for the Study of Aging and Human Development, Duke University Medical Center, Durham, North Carolina, United States of America
- Geriatric Research, Education and Clinical Center, Durham Veterans Affairs Medical Center, Durham, North Carolina, United States of America
- Department of Medicine, Division of Geriatrics, Duke University, Durham, North Carolina, United States of America
| | - Paul E. Wischmeyer
- Duke University Hospital, Department of Anesthesiology and Surgery, Durham North Carolina, United States of America
| | - David Macleod
- Human Pharmacology and Physiology Lab, Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina, United States of America
| | - Jeroen Molinger
- Duke University Hospital, Department of Anesthesiology and Surgery, Durham North Carolina, United States of America
- Human Pharmacology and Physiology Lab, Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina, United States of America
| | - Stratton Barth
- Duke University Hospital, Department of Anesthesiology and Surgery, Durham North Carolina, United States of America
| | - Sin-Ho Jung
- Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, North Carolina, United States of America
| | - Harvey Jay Cohen
- Center for the Study of Aging and Human Development, Duke University Medical Center, Durham, North Carolina, United States of America
- Department of Medicine, Duke University Medical Center, Durham, North Carolina, United States of America
| | - David B. Bartlett
- Division of Medical Oncology, Duke University School of Medicine, Durham, North Carolina, United States of America
- School of Biosciences and Medicine, University of Surrey, Guildford, United Kingdom
| | - Anthony D. Sung
- Division of Hematologic Malignancies and Cellular Therapy, Department of Medicine, Duke University Medical Center, Durham, North Carolina, United States of America
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Dillon HT, Foulkes S, Horne-Okano YA, Kliman D, Dunstan DW, Daly RM, Fraser SF, Avery S, Kingwell BA, La Gerche A, Howden EJ. Reduced cardiovascular reserve capacity in long-term allogeneic stem cell transplant survivors. Sci Rep 2023; 13:2112. [PMID: 36747066 PMCID: PMC9902607 DOI: 10.1038/s41598-023-28320-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 01/17/2023] [Indexed: 02/08/2023] Open
Abstract
Premature cardiovascular mortality is increased in long-term allogeneic stem cell transplant (allo-SCT) survivors, but little information exists regarding subclinical cardiovascular dysfunction in this population. We compared peak oxygen uptake ([Formula: see text]O2peak), a prognostic cardiovascular marker, and its determinants between long-term allo-SCT survivors and non-cancer controls. Fourteen allo-SCT survivors (mean ± SD, 44 ± 15 years, 50% male, median time since allo-SCT: 6.5 years [range 2-20]) and 14 age- and sex-matched controls (46 ± 13 years, 50% male) underwent cardiopulmonary exercise testing to quantify [Formula: see text]O2peak. Resting echocardiography (left-ventricular ejection fraction and strain), exercise cardiac MRI (peak cardiac and stroke volume index [CIpeak, SVIpeak]), biochemistry (hemoglobin, troponin-I, B-natriuretic peptide), dual-energy x-ray absorptiometry (lean [LM] and fat [FM] mass, percent body fat [%BF]) and Fick-principal calculation (arteriovenous oxygen difference) were also performed. Survivors exhibited impaired [Formula: see text]O2peak as compared with controls (25.9 ± 5.1 vs. 33.7 ± 6.5 ml kg-1 min-1, p = 0.002), which coincided with reduced CIpeak (6.6 ± 0.8 vs. 8.6 ± 1.9 L min-1 m-2; p = 0.001) secondary to reduced SVIpeak (48 ± 4 vs. 61 ± 8 ml m-2; p < 0.001) rather than chronotropic impairment, and higher %BF (difference, 7.9%, p = 0.007) due to greater FM (5.8 kg; p = 0.069) and lower LM (4.3 kg, p = 0.25). All other measures were similar between groups. Despite comparable resting cardiac function and biomarker profiles, survivors exhibited reduced [Formula: see text]O2peak and exercise cardiac function and increased %BF relative to controls. These results highlight potential therapeutic avenues and the utility of exercise-based cardiovascular assessment in unmasking cardiovascular dysfunction in allo-SCT survivors.
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Affiliation(s)
- Hayley T Dillon
- Baker Heart and Diabetes Institute, Melbourne, Australia.,Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Stephen Foulkes
- Baker Heart and Diabetes Institute, Melbourne, Australia.,Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia.,University of Melbourne, Melbourne, Australia
| | | | - David Kliman
- Malignant Haematology and Stem Cell Transplantation Service, Alfred Hospital, Melbourne, Australia
| | - David W Dunstan
- Baker Heart and Diabetes Institute, Melbourne, Australia.,Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Robin M Daly
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Steve F Fraser
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Sharon Avery
- Malignant Haematology and Stem Cell Transplantation Service, Alfred Hospital, Melbourne, Australia
| | - Bronwyn A Kingwell
- Baker Heart and Diabetes Institute, Melbourne, Australia.,CSL Ltd, Melbourne, Australia
| | - Andre La Gerche
- Baker Heart and Diabetes Institute, Melbourne, Australia.,University of Melbourne, Melbourne, Australia.,Cardiology Department, St Vincent's Hospital Melbourne, Fitzroy, Australia
| | - Erin J Howden
- Baker Heart and Diabetes Institute, Melbourne, Australia. .,University of Melbourne, Melbourne, Australia.
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Massey RJ, Myrdal OH, Diep PP, Burman MM, Brinch L, Gullestad LL, Ruud E, Aakhus S, Beitnes JO. Reduced exercise capacity is associated with left ventricular systolic dysfunction in long-term survivors of allogeneic hematopoietic stem-cell transplantation. JOURNAL OF CLINICAL ULTRASOUND : JCU 2023; 51:5-15. [PMID: 35788941 PMCID: PMC10084426 DOI: 10.1002/jcu.23264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Revised: 05/25/2022] [Accepted: 05/25/2022] [Indexed: 06/15/2023]
Abstract
PURPOSE Exercise intolerance is a common complication in survivors of allogeneic hematopoietic stem-cell transplantation (allo-HSCT). The aim of this study was to determine if cardiac function measured with echocardiography is associated with exercise capacity measured with cardio-pulmonary exercise tests in long-term survivors treated in their youth with allo-HSCT. METHODS The study included 96 patients, of which 54.2% were female, aged 34.9 ± 11.6 years and 17.7 ± 9.3 years after allo-HSCT. Reduced exercise capacity was defined as <85% of predicted-peak oxygen uptake (VO2peak ). Linear regression was used in the prediction of VO2peak (ml/kg/min). Receiver operating characteristic evaluated the accuracy of predicting reduced exercise capacity. RESULTS VO2peak was 36.2 ± 7.7 ml/kg/min and 43 (44.8%) had reduced exercise capacity. Left ventricular ejection fraction was 55.4 ± 5.9% and global longitudinal strain (GLS) was -17.6% ± 2.0%. Left and right ventricular functions were significantly lower in survivors with reduced exercise capacity. Increased body mass index, lower physical activity score, reduced pulmonary function (by forced expiratory volume in 1-s) and reduced left ventricular systolic function (by GLS) were significant independent predictors for reduced VO2peak . GLS was superior to other echocardiographical indices for identifying reduced exercise capacity (area under curve = 0.64, p = 0.014). CONCLUSIONS Left ventricular systolic dysfunction measured by GLS is associated with reduced exercise capacity in long-term allo-HSCT survivors.
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Affiliation(s)
- Richard John Massey
- Department of CardiologyOslo University HospitalOsloNorway
- Institute for Clinical MedicineFaculty of Medicine, University of OsloOsloNorway
| | - Ole Henrik Myrdal
- Institute for Clinical MedicineFaculty of Medicine, University of OsloOsloNorway
- Department of Respiratory MedicineOslo University HospitalOsloNorway
| | - Phoi Phoi Diep
- Institute for Clinical MedicineFaculty of Medicine, University of OsloOsloNorway
- Department of Hematology and Oncology, Division of Pediatric and Adolescent MedicineOslo University HospitalOsloNorway
- Department of Pediatric Research, Division of Pediatric and Adolescent MedicineOslo University HospitalOsloNorway
| | - Marta Maria Burman
- Institute for Clinical MedicineFaculty of Medicine, University of OsloOsloNorway
- Department of Hematology and Oncology, Division of Pediatric and Adolescent MedicineOslo University HospitalOsloNorway
- Department of Pediatric Research, Division of Pediatric and Adolescent MedicineOslo University HospitalOsloNorway
| | - Lorentz Brinch
- Department of HematologyOslo University HospitalOsloNorway
| | - Lars Lysgaard Gullestad
- Department of CardiologyOslo University HospitalOsloNorway
- Institute for Clinical MedicineFaculty of Medicine, University of OsloOsloNorway
- KG Jebsen Center for Cardiac ResearchUniversity of OsloOsloNorway
- Center for Heart Failure ResearchOslo University HospitalOsloNorway
| | - Ellen Ruud
- Institute for Clinical MedicineFaculty of Medicine, University of OsloOsloNorway
- Department of Hematology and Oncology, Division of Pediatric and Adolescent MedicineOslo University HospitalOsloNorway
| | - Svend Aakhus
- Department of Circulation and Imaging, Faculty of Medicine and Health ScienceNorwegian University of Science and TechnologyTrondheimNorway
- Clinic of CardiologySt. Olavs HospitalTrondheimNorway
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Tanem KE, Wilberg P, Diep PP, Ruud E, Skaare AB, Brinch L, Herlofson BB. Oral chronic GVHD after allogeneic stem cell transplantation without total body irradiation performed at a young age. Support Care Cancer 2022; 30:4121-4128. [PMID: 35075489 PMCID: PMC8942927 DOI: 10.1007/s00520-022-06836-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 01/13/2022] [Indexed: 11/17/2022]
Abstract
PURPOSE Long-term survivors (LTSs) of allogeneic hematopoietic stem cell transplantation (allo-HCT) may experience oral long-term effects like chronic graft-versus-host disease (oral cGVHD). The aim of this study was to investigate oral cGVHD in patients treated at a young age (< 30 years) more than 5 years after allo-HCT without total body irradiation (TBI). METHODS All 94 participants went through a semi-structured interview, and an oral examination. Diagnosis of oral cGVHD was based on the "National Institutes of Health (NIH) cGVHD diagnosis and staging consensus criteria" from 2014. RESULTS Mean age at transplantation was 17.5 years (range 0.4-29.9 years), and mean time since transplantation was 16.7 years (range 6-26 years). Oral cGVHD was diagnosed in 26 (28%) of 94 LTSs. Of which 20 (21.5%) showed lichen planus-like (LPL) changes, and additionally six (6.5%) also fulfilled the diagnostic criteria of oral cGVHD since they had one or more distinctive signs and symptoms of oral cGVHD combined with definite cGVHD in another organ. No LTSs reported oral cGVHD (NIH) grade 3. There was a significant association between cGVHD in the oral cavity and cGVHD in another organ (77% vs 29%, p < 0.001). Out of 72 LTSs, who answered the questions regarding taste disturbances, 16 (22%) reported dysgeusia. No LTSs developed secondary malignancies in the oral cavity during follow-up time. CONCLUSION Oral long-term effects, such as oral cGVHD, may persist for many years after allo-HCT without TBI-conditioning in patients treated at a young age.
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Affiliation(s)
- Kristine Eidal Tanem
- Department of Oral Surgery and Oral Medicine, Faculty of Dentistry, University of Oslo, Postbox 1109 Blindern, N-0317, Oslo, Norway.
| | - Petter Wilberg
- Department of Oral Surgery and Oral Medicine, Faculty of Dentistry, University of Oslo, Postbox 1109 Blindern, N-0317, Oslo, Norway
| | - Phoi Phoi Diep
- Department of Pediatric Oncology and Hematology, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ellen Ruud
- Department of Pediatric Oncology and Hematology, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Anne B Skaare
- Department of Pediatric Dentistry and Behavioral Science, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Lorentz Brinch
- Department of Hematology, Oslo University Hospital, Oslo, Norway
| | - Bente Brokstad Herlofson
- Department of Oral Surgery and Oral Medicine, Faculty of Dentistry, University of Oslo, Postbox 1109 Blindern, N-0317, Oslo, Norway
- Unit of Oral and Maxillofacial Surgery, Division for Head, Neck, and Reconstructive Surgery, Department of Otorhinolaryngology, Oslo University Hospital, Oslo, Norway
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