Non-endocrine late complications in children after allogeneic haematopoietic SCT

Area of Science:

• Pediatric Hematology
• Transplant Immunology
• Oncology

Background:

• Children surviving hematopoietic stem cell transplant (HSCT) can experience diverse long-term non-endocrine complications.
• These late sequelae arise from preparative regimens (chemotherapy, radiotherapy), immune reconstitution, and chronic graft-versus-host disease (GvHD).

Purpose of the Study:

• To review the spectrum of late non-endocrine complications in pediatric HSCT survivors.
• To highlight the role of immune reconstitution and GvHD in late clinical abnormalities and infections.
• To discuss risks associated with novel transplant modalities and increased risk of second malignancies.

Main Methods:

• Literature review focusing on long-term complications after pediatric HSCT.
• Analysis of factors contributing to late sequelae, including preparative regimens and immune-related events.
• Examination of risks associated with advanced HSCT techniques and surveillance strategies.

Main Results:

• Preparative regimens can cause permanent organ damage.
• Immune reconstitution and chronic GvHD are key factors in late complications and infections.
• Novel transplant modalities may increase autoimmune syndromes; chemo/radiotherapy elevates second malignancy risk.

Conclusions:

• A proactive surveillance strategy is essential for vigilant post-transplant care in pediatric HSCT survivors.
• Paediatricians must be knowledgeable in monitoring and managing these potential complications.
• Effective management aims to minimize suffering and healthcare costs, representing a significant challenge in pediatric HSCT.