The Impact of Donor Type on Long-Term Health Status and Quality of Life ă after Allogeneic Hematopoietic Stem Cell Transplantation for Childhood ă Acute Leukemia: A Leucemie de l'Enfant et de L'Adolescent Study

We compared the long-term impact of donor type (sibling donor [SD] ă versus matched unrelated donor [MUD] or umbilical cord blood [UCB]) ă on late side effects and quality of life (QoL) in childhood acute ă leukemia survivors treated with hematopoietic stem cell transplantation. ă We included 314 patients who underwent transplantation from 1997 to 2012 ă and were enrolled in the multicenter French Leucemie de l'Enfant et de ă L'Adolescent (''Leukemia in Children and Adolescents'') cohort. More ă than one-third of the patients were adults at last visit; mean follow-up ă duration was 6.2 years. At least 1 late effect was observed in 284 of ă 314 patients (90.4%). The average number of adverse late effects was ă 2.1 +/- 1, 2.4 +/- 2, and 2.4 +/- 2 after SD, MUD, and UCB ă transplantation, respectively. In a multivariate analysis, considering ă the SD group as the reference, we did not detect an impact of donor type ă for most sequelae, with the exception of increased risk of major growth ă failure after MUD transplantation (odds ratio [OR], 2.42) and elevated ă risk of osteonecrosis after UCB transplantation (OR, 4.15). The adults ă and children's parents reported comparable QoL among the 3 groups. Adult ă patient QoL scores were lower than age- and sex-matched French reference ă scores for almost all dimensions. We conclude that although these ă patients are heavily burdened by long-term complications, donor type had ă a very limited impact on their long-term health status and QoL. (C) 2016 ă American Society for Blood and Marrow Transplantation.