Increased Susceptibility to Long-Term Complications in Leukemia Survivors Who Received Hematopoietic Stem Cell Transplantation During Adolescence
Abstract
Hematopoietic stem cell transplantation (HSCT) is essential for curing high-risk or relapsed acute leukemia but entails lifelong morbidities. Adolescents and young adults may be particularly vulnerable; however, data on the global risk of long-term complications in survivors who underwent HSCT during adolescence are lacking. Using the French Leucémie Enfant Adolescent cohort, we compared late complications and quality of life (QoL) in survivors transplanted at ≥15 versus <15 yr. We included 168 adolescents (≥15 yr of age at HSCT) and 446 children (<15 yr of age at HSCT) matched at best 1:3 on sex, type of leukemia, total body irradiation use, history of relapse, and follow-up duration. Cumulative morbidity was modelled with a five-state multistate model (0 to ≥4 complications). After a mean follow-up of 8.8 yr for adolescents and 9.5 yr for children, adolescents had a mean of 2.1 ± 0.1 complications compared with 1.6 ± 0.1 in younger survivors (P < .001). Higher incidences were noted for cardiomyopathy, chronic kidney disease, secondary neoplasms, iron overload, and osteonecrosis. The multi-state model revealed earlier onset and faster accumulation of complications in adolescents. QoL scores did not differ between groups. HSCT during adolescence is associated with earlier and heavier long-term morbidity, underscoring the need for age-tailored survivorship care and integration of adolescent and young adults-specific risks into follow-up guidelines.
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BibTeX
@article{pessarossi2026increased,
title = {{Increased Susceptibility to Long-Term Complications in Leukemia Survivors Who Received Hematopoietic Stem Cell Transplantation During Adolescence}},
author = {Léna Pessarossi and Marilyne Poiree and Jean-Hugues Dalle and Sandrine Visentin and Carine Domenech and Cecile Renard and Cécile Pochon and André Baruchel and Mony Fahd and Virginie Gandemer and Charlotte Jubert and Stéphane Ducassou and Catherine Paillard and Laura Olivier-Gougenheim and Alexandre Theron and Dominique Plantaz and Marie-Dominique Tabone and Guy Leverger and Justyna Kanold and Sandrine Thouvenin-Doulet and Zeinab Hamidou and Mohamed Boucekine and Julie Berbis and Pascal Auquier and Gérard Michel and Paul Saultier},
journal = {Transplantation and Cellular Therapy},
year = {2026},
month = oct,
doi = {10.1016/j.jtct.2026.04.050},
url = {https://hal.science/hal-05657630v1},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Increased Susceptibility to Long-Term Complications in Leukemia Survivors Who Received Hematopoietic Stem Cell Transplantation During Adolescence
AU - Léna Pessarossi
AU - Marilyne Poiree
AU - Jean-Hugues Dalle
AU - Sandrine Visentin
AU - Carine Domenech
AU - Cecile Renard
AU - Cécile Pochon
AU - André Baruchel
AU - Mony Fahd
AU - Virginie Gandemer
AU - Charlotte Jubert
AU - Stéphane Ducassou
AU - Catherine Paillard
AU - Laura Olivier-Gougenheim
AU - Alexandre Theron
AU - Dominique Plantaz
AU - Marie-Dominique Tabone
AU - Guy Leverger
AU - Justyna Kanold
AU - Sandrine Thouvenin-Doulet
AU - Zeinab Hamidou
AU - Mohamed Boucekine
AU - Julie Berbis
AU - Pascal Auquier
AU - Gérard Michel
AU - Paul Saultier
PY - 2026
DA - 2026/10/13
JO - Transplantation and Cellular Therapy
DO - 10.1016/j.jtct.2026.04.050
UR - https://hal.science/hal-05657630v1
AB - Hematopoietic stem cell transplantation (HSCT) is essential for curing high-risk or relapsed acute leukemia but entails lifelong morbidities. Adolescents and young adults may be particularly vulnerable; however, data on the global risk of long-term complications in survivors who underwent HSCT during adolescence are lacking. Using the French Leucémie Enfant Adolescent cohort, we compared late complications and quality of life (QoL) in survivors transplanted at ≥15 versus <15 yr. We included 168 adolescents (≥15 yr of age at HSCT) and 446 children (<15 yr of age at HSCT) matched at best 1:3 on sex, type of leukemia, total body irradiation use, history of relapse, and follow-up duration. Cumulative morbidity was modelled with a five-state multistate model (0 to ≥4 complications). After a mean follow-up of 8.8 yr for adolescents and 9.5 yr for children, adolescents had a mean of 2.1 ± 0.1 complications compared with 1.6 ± 0.1 in younger survivors (P < .001). Higher incidences were noted for cardiomyopathy, chronic kidney disease, secondary neoplasms, iron overload, and osteonecrosis. The multi-state model revealed earlier onset and faster accumulation of complications in adolescents. QoL scores did not differ between groups. HSCT during adolescence is associated with earlier and heavier long-term morbidity, underscoring the need for age-tailored survivorship care and integration of adolescent and young adults-specific risks into follow-up guidelines.
SN - 2666-6367
ER -