Cataracts after total body irradiation and bone marrow transplantation in patients with acute leukemia in complete remission: a study of the European Group for Blood and Marrow Transplantation

Détails

ID Serval
serval:BIB_DC871FB2FBCA
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Cataracts after total body irradiation and bone marrow transplantation in patients with acute leukemia in complete remission: a study of the European Group for Blood and Marrow Transplantation
Périodique
International Journal of Radiation Oncology, Biology, Physics
Auteur(s)
Belkacemi  Y., Labopin  M., Vernant  J. P., Prentice  H. G., Tichelli  A., Schattenberg  A., Boogaerts  M. A., Ernst  P., Della Volpe  A., Goldstone  A. H., Jouet  J. P., Verdonck  L. F., Locasciulli  A., Rio  B., Ozsahin  M., Gorin  N. C.
ISSN
0360-3016
Statut éditorial
Publié
Date de publication
06/1998
Peer-reviewed
Oui
Volume
41
Numéro
3
Pages
659-68
Notes
Journal Article --- Old month value: Jun 1
Résumé
PURPOSE: Advances in bone marrow transplantation (BMT) have consistently improved long-term survival. Therefore, evaluation of late complications such as cataracts is of paramount importance. METHODS AND MATERIALS: We analyzed data of 2149 patients from the EBMT registry. A cohort of 1063 patients were evaluable for survival and ophthalmologic status after transplant for acute leukemia (AL) in first or second complete remission. Conditioning therapy included either single-dose total body irradiation (STBI) or fractionated TBI (FTBI) grouped in different dose rates (low: LDR < or = 0.04 Gy/min; high: HDR > 0.04 Gy/min). RESULTS: The overall 10-year estimated cataract incidence (ECI) was 50%. It was 60% in the STBI group, 43% in the FTBI group < or = 6 fractions, and 7% in the FTBI group > 6 fractions (p < 10(-4)). It was significantly lower (30%) in the LDR than in the HDR groups (59%;p < 10(-4)). Patients receiving heparin for veno-occlusive disease prophylaxis had fewer cataracts than those who did not (10-year ECI: 33% vs. 53%, respectively;p = 0.04). The 10-year ECI was 65% in the allogeneic vs. 46% in the autologous BMT patients (p = 0.0018). Factors independently associated with an increased risk of cataract were an older age (> 23 years), higher dose rate (> 0.04 Gy/min), allogeneic BMT, and steroid administration (> 100 days). The use of FTBI was associated with a decreased risk of cataract. Heparin administration was a protective factor in patients receiving STBI. In terms of cataract surgery, the unfavorable factors for requiring surgery were: age > 23 yr, STBI, dose rate > 0.04 Gy/min, chronic graft-vs.-host disease (cGvHD), and absence of heparin administration. Among the patients who required cataract surgery (111 out of 257), secondary posterior capsular opacification was observed in 15.7%. CONCLUSION: High dose rate and STBI are the main risk factors for cataract development and the need for surgery, and the administration of heparin has a protective role in cataractogenesis.
Mots-clé
Adolescent Adult Age Factors Analysis of Variance Bone Marrow Transplantation/*adverse effects Cataract/*etiology Cataract Extraction Child Child, Preschool Female Humans Infant Male Middle Aged Retrospective Studies Time Factors Transplantation Conditioning/*adverse effects Whole-Body Irradiation/*adverse effects
Pubmed
Web of science
Création de la notice
24/01/2008 17:16
Dernière modification de la notice
20/08/2019 16:01
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