Treatment-related deaths and second XXXX risk after autologous stem-cell transplantation for @entity978 .

@entity1 @entity137 @entity66 @entity5 @entity2590 @entity3052 @entity978
Autologous stem-cell transplantation has become a widely used therapy in @entity978 ( @entity978 ). To appreciate the early and late risks associated with this procedure, its lethal @entity137 and effects on the incidence of @entity5 were studied. Data related to 467 French @entity1 grafted from 1982 to 1995 for primary sensitive disease (PSD, 22%), @entity66 ( @entity66 , 18%), first relapse (R1, 45%), or subsequent relapses (R2, 15%) were analyzed. Grafted @entity1 (PSD, @entity66 , and R1; n = 393) were matched (3 controls for 1 case) on age, gender, clinical stage, B symptoms, and time at risk with 1179 conventionally treated @entity1 issued from international databases. The proportional hazards (Cox) model was used to assess relative risks (RR). Among grafted @entity1 , 8% died of @entity137 related to the procedure, and 18 @entity5 occurred leading to a 5-year cumulative incidence rate of 8.9%. In this series, risk factors for second @entity5 were age >/=40 years (RR = 3.73, P = .007) and the use of peripheral blood stem cells as source of graft (RR = 3.10, P = .03). Among grafted and matched ungrafted @entity1 , risk factors for the development of secondary @entity5 were age >/=40 years (RR = 2.90, P < .001), relapse versus no relapse (RR = 5.22, P = .006), @entity66 versus other @entity1 (RR = 3.86, P = .033), and grafted versus ungrafted @entity1 (RR = 2.04, P = . 024). @entity5 were more frequent in grafted than in ungrafted @entity1 (RR = 5.19, P = .001) although the incidence of @entity2590 and @entity3052 was similar in the two groups. We conclude that high-dose chemotherapy administered as first-line treatment or after relapse is associated with an acceptable toxic death rate. The risk of secondary @entity2590 or @entity3052 is not significantly increased after autologous stem-cell transplantation for @entity978 , whereas an increased risk of solid @entity5 exists. The peripheral blood stem-cell-associated risk of secondary @entity5 among grafted @entity1 needs further investigations.
