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.
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.
Authors: Yoshihiro Inamoto; Igor Petriček; Linda Burns; Saurabh Chhabra; Zachariah DeFilipp; Peiman Hematti; Alicia Rovó; Raquel Schears; Ami Shah; Vaibhav Agrawal; Aisha Ahmed; Ibrahim Ahmed; Asim Ali; Mahmoud Aljurf; Hassan Alkhateeb; Amer Beitinjaneh; Neel Bhatt; Dave Buchbinder; Michael Byrne; Natalie Callander; Kristina Fahnehjelm; Nosha Farhadfar; Robert Peter Gale; Siddhartha Ganguly; Shahrukh Hashmi; Gerhard C Hildebrandt; Erich Horn; Ann Jakubowski; Rammurti T Kamble; Jason Law; Catherine Lee; Sunita Nathan; Olaf Penack; Ravi Pingali; Pinki Prasad; Drazen Pulanic; Seth Rotz; Aditya Shreenivas; Amir Steinberg; Khalid Tabbara; André Tichelli; Baldeep Wirk; Jean Yared; Grzegorz W Basak; Minoo Battiwalla; Rafael Duarte; Bipin N Savani; Mary E D Flowers; Bronwen E Shaw; Nuria Valdés-Sanz Journal: Biol Blood Marrow Transplant Date: 2018-12-03 Impact factor: 5.742
Authors: Alicia Rovó; Thomas Daikeler; Jörg Halter; Dominik Heim; Dimitrios A Tsakiris; Martin Stern; Tuomas Waltimo; Jan Dirk Studt; Alan Tyndall; Alois Gratwohl; André Tichelli Journal: Haematologica Date: 2010-09-17 Impact factor: 9.941
Authors: Yoshihiro Inamoto; Igor Petriček; Nuria Valdés-Sanz; Linda Burns; Saurabh Chhabra; Zack DeFilipp; Peiman Hematti; Alicia Rovó; Raquel Schears; Ami Shah; Vaibhav Agrawal; Aisha Al-Khinji; Ibrahim Ahmed; Asim Ali; Mahmoud Aljurf; Hassan Alkhateeb; Amer Beitinjaneh; Neel Bhatt; Dave Buchbinder; Michael Byrne; Natalie Callander; Kristina Fahnehjelm; Nosha Farhadfar; Robert Peter Gale; Siddhartha Ganguly; Gerhard C Hildebrandt; Erich Horn; Ann Jakubowski; Rammurti T Kamble; Jason Law; Catherine Lee; Sunita Nathan; Olaf Penack; Ravi Pingali; Pinki Prasad; Drazen Pulanic; Seth Rotz; Aditya Shreenivas; Amir Steinberg; Khalid Tabbara; André Tichelli; Baldeep Wirk; Jean Yared; Grzegorz W Basak; Minoo Battiwalla; Rafael Duarte; Bipin N Savani; Mary E D Flowers; Bronwen E Shaw Journal: Bone Marrow Transplant Date: 2019-02-27 Impact factor: 5.483
Authors: André Tichelli; Myriam Labopin; Alicia Rovó; Manuela Badoglio; Mutlu Arat; Maria Teresa van Lint; Anita Lawitschka; Carl Philipp Schwarze; Jakob Passweg; Gérard Socié Journal: Cancer Date: 2013-03-19 Impact factor: 6.860