Long-term outcome of allogeneic stem cell transplant: Single institution experience of a large cohort
Bibliographic record
Abstract
Background and Methods: We analyzed the late outcome of long-term survivors of allogeneic stem cell transplantation (allo-SCT) treated by the Leukemia/Bone Marrow Transplant Program of British Columbia. Results: We reviewed the charts of 430 patients (pts) who received allo-SCT between 1981 and 2002 for hematologic malignancies and who were free of their primary disease for at least two years after transplant. Late recurrent primary malignancy was found in 13% (57 pts) of allo-SCT recipients and was the primary cause of late death. 31 (7%) allo-SCT recipients died of non-relapse causes at a median of 5.5 year (range 2 to 15.6) post allo-SCT. Non relapse causes of death were GVHD (11 pts), second cancer (8), coronary disease (3), infection (2), miscellaneous (5), and unknown (2). 342 non relapse long-term allo-SCT survivors were evaluated for late complications. Median follow-up for the survivors was 8 (range 2 to 23) years. Chronic graft versus host disease (cGVHD) was diagnosed in 205 (60%) survivors with more than 50% of pts still having symptoms of cGVHD at last follow-up. Cardiovascular complications in survivors included hypertension (21%), coronary disease (3%) and myocardial infarction (2%). Renal failure was diagnosed in 64 (17%) survivors; it resolved over time in 17 pts; 6 pts needed dialysis. Endocrine complications seen in survivors included dyslipidemia (10%), hypothyroidism (9%), diabetes (7%), osteopenia/osteoporosis (25%), hypogonadism in females (76%) and hypogonadism in males (7%). Depression was reported in 41 (11%) survivors, and 2 pts attempted suicide. Cognitive impairment and other psychiatric problems were identified in 2% and 3% respectively. Sexual dysfunction was reported in 6% of survivors. Conclusions: In patients who receive allo-SCT as treatment for hematologic malignancy and who are disease-free 2 years post transplant, probability of durable remission is high with acceptable but definite late toxicity. The occurrence of late events necessitates lifelong medical surveillance.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".