Cause-specific late mortality after allogeneic stem cell transplantation

Conditional on surviving the first 2 to 5 years after allogeneic blood or marrow transplantation (BMT), the 10-year overall survival approaches 80%. Nonetheless, the risk of late mortality remains higher than the age- and sex-matched general population for several years after BMT. The higher mortality rates in transplant recipients translate into shorter projected life expectancies compared with the general population. Risk of relapse-related mortality reaches a plateau within 10 years after BMT. With increasing time from BMT, nonrelapse-related mortality becomes the leading cause of death, and continues to increase with time after BMT. The major causes of nonrelapse mortality include infection (with or without chronic graft-versus-host disease), subsequent neoplasms, and cardiopulmonary compromise. In this review, findings from large cohorts are summarized, identifying opportunities for risk-based anticipatory intervention strategies to reduce mortality.