Hematopoietic Stem Cell Transplantation in patients with Fanconi Anemia: A report of late effects and psychosocial adjustment in life

Abstract

Abstract Stem cell transplantation (HCT) restores normal hematopoiesis in Fanconi anemia patients but survivors remain prone to long-term complications. This study was conducted to review the late effects and psychosocial adjustment in life for long term survivors of FA patients. Medical records of 149 patients with FA who underwent allogeneic HCT were reviewed. Cumulative probabilities of OS at 10- and 15 years were 76.6%±3.6% and 69.8%±4.4% respectively. Median OS time was 22.8 years. Eighty-seven patients were successfully contacted for follow up. Late-effects were reported by 47. The most commonly reported late-effects were hypothyroidism, amenorrhea and ocular problems. About two-third of our alive patients (n = 58, 66.7%) had achieved a minimum of high school education; only three (3.4%) got married. None had children. Of those 45 patients who were above 20 years of age at last contact, 42 (93.3%) were still living with their parents, two (5.0%) had rental accommodation and one female was living independently. Only nine (20%) of recipients who were above 20 years of age were able to secure an employment, two of whom were self-employed. Long term close follow-up is crucial to detect such complications. Psychological and social counseling should be an integral part of their follow up.