Survival and late mortality among patients who survived disease‐free for 2 years after stem cell transplantation

Abstract

SummaryMost events that limit life expectancy after allogeneic haematopoietic stem cell transplantation (allo‐HSCT) occur within the first 2 years; however, treatment outcomes in long‐term survivors who survive for at least 2 years post‐HSCT without relapse are yet to be elucidated. To explore the life expectancy trends and late complications and to assess the main mortality‐related factors, we investigated the characteristics of patients who received allo‐HSCT for haematological malignancies from 2007 to 2019 in our centre and survived in remission for 2 years. A cohort of 831 patients was enrolled; of these, 508 received grafts from haploidentical‐related donors (61.1%). The estimated overall survival rate at 10 years was 91.9% (95% confidence interval [CI], 89.8–93.5), which was affected by prior grade III–IV acute graft‐versus‐host disease (GVHD) (hazard ratio [HR], 2.98; 95% CI, 1.47–6.03; p = 0.002) and severe chronic GVHD (HR, 3.60; 95% CI, 1.93–6.71; p < 0.001). The probability of late relapse and non‐relapse mortality at 10 years was 8.7% (95% CI, 6.9–10.8) and 3.6% (95% CI, 2.5–5.1) respectively. The top cause of late mortality was relapsed (49.0%). Projected long‐term survival in 2‐year disease‐free survivors following allo‐HSCT was excellent. Strategies should be implemented to minimise the late death‐specific hazards in recipients.