Increased susceptibility to long-term complications in leukemia survivors who received hematopoietic stem cell transplantation during adolescence
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 (LEA) cohort, we compared late complications and quality of life (QoL) in survivors transplanted at ≥15 years versus <15 years. We included 168 adolescents (≥15 years of age at HSCT) and 446 children (<15 years 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 years for adolescents and 9.5 years for children, adolescents had a mean of 2.1±0.1 complications compared with 1.6±0.1 in younger survivors (p <0.001). 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 AYA-specific risks into follow-up guidelines.
Authors
- C. Rénard (ORCID: https://orcid.org/0000-0002-2587-0294)
- Alexandre Théron (ORCID: https://orcid.org/0000-0001-8793-4903)
- Marilyne Poirée (ORCID: https://orcid.org/0000-0001-5515-8794)
- Zeinab Hamidou
- Cécile Pochon (ORCID: https://orcid.org/0000-0003-0277-5611)
- Sandrine Thouvenin‐Doulet
- Sandrine Visentin
- Stéphane Ducassou (ORCID: https://orcid.org/0000-0001-7736-0838)
- Paul Saultier (ORCID: https://orcid.org/0000-0002-6327-0898)
- V Gandemer
- Charlotte Jubert
- Mohamed Boucékine (ORCID: https://orcid.org/0000-0002-6129-4386)
- G. Leverger
- Carine Domenech (ORCID: https://orcid.org/0000-0002-9349-4139)
- Laura Olivier‐Gougenheim (ORCID: https://orcid.org/0000-0003-2908-5768)
- Julie Berbis
- Mony Fahd
- Gérard Michel
- Pascal Auquier
- Marie-Dominique Tabone (ORCID: https://orcid.org/0000-0002-9486-8454)
- Léna Pessarossi
- Dominique Plantaz
- Jean-Hugues Dalle
- Justyna Kanold
- Catherine Paillard (ORCID: https://orcid.org/0000-0003-1662-5446)
- André Baruchel
Institutions
- Université Claude Bernard Lyon 1 (FR)
- Université de Bordeaux (FR)
- Inserm (FR)
- Université Fédérale de Toulouse Midi-Pyrénées (FR)
- Aix-Marseille Université (FR)
- Centre Hospitalier Universitaire de Grenoble (FR)
- Sorbonne Université (FR)
- Hôpital Armand-Trousseau (FR)
- Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement (FR)
- Centre Hospitalier Universitaire de Montpellier (FR)
- Assistance Publique – Hôpitaux de Paris (FR)
- Hospices Civils de Lyon (FR)
- Hôpital d'Enfants (FR)
- Hôpital l'Archet (FR)
- Hôpital Robert-Debré (FR)
- Centre Hospitalier Universitaire de Rennes (FR)
- Centre Hospitalier Universitaire de Saint-Étienne (FR)
- Hôpital de la Timone (FR)
- Université de Rennes (FR)
- Université de Strasbourg (FR)
- Université Grenoble Alpes (FR)
Publication Details
- Journal
- Transplantation and Cellular Therapy
- Published
- 2026-05-01
- DOI
- https://doi.org/10.1016/j.jtct.2026.04.050
- Primary Topic
- Childhood Cancer Survivors' Quality of Life
- Type
- article
- Field-Weighted Citation Impact
- 0.00
Funders
- Association Laurette Fugain
- Agence Nationale de la Recherche
- Institut National de la Santé et de la Recherche Médicale
- Ligue Contre le Cancer
- Institut National Du Cancer
- Fédération Enfants Cancers Santé
- Canceropôle Provence-Alpes-Côte d’Azur