Predictors of Loss to Follow-Up Among Pediatric and Adult Hematopoietic Cell Transplantation Survivors: A Report from the Center for International Blood and Marrow Transplant Research

D. Buchbinder*, R. Brazauskas, K. Bo-Subait, K. Ballen, S. Parsons, T. Johns, T. Hahn, A. Sharma, A. Steinbergs, A. D'Souza, A.J. Kumar, A. Yoshimi, B. Wirk, B. Shawl, C. Freytes, C. LeMaistre, C. Bredeson, C. Dandoy, D. Almaguer, D.I. MarksD. Szwajcer, G. Hale, H. Schouten, H. Hashem, H. Schoemans, H.S. Murthy, H.M. Lazarus, J. Cerny, J. Tay, J.A. Yared, K. Adekola, K.R. Schultz, L. Lehmann, L. Burns, M. Aljurf, M.A. Diaz, N. Majhail, N. Farhadfar, R. Kamble, R. Olsson, R. Schears, S. Seo, S. Beattie, S. Chhabra, B.N. Savani, S. Badawy, S. Ganguly, S. Ciurea, S. Marino, U. Gergis

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

5 Citations (Web of Science)


Follow-up is integral for hematopoietic cell transplantation (HCT) care to ensure surveillance and intervention for complications. We characterized the incidence of and predictors for being lost to follow-up. Two-year survivors of first allogeneic HCT (10,367 adults and 3865 children) or autologous HCT (7291 adults and 467 children) for malignant/nonmalignant disorders between 2002 and 2013 reported to the Center for International Blood and Marrow Transplant Research were selected. The cumulative incidence of being lost to follow-up (defined as having missed 2 consecutive follow-up reporting periods) was calculated. Marginal Cox models (adjusted for center effect) were fit to evaluate predictors. The 10-year cumulative incidence of being lost to follow-up was 13% (95% confidence interval [CI], 12% to 14%) in adult allogeneic HCT survivors, 15% (95% CI, 14% to 16%) in adult autologous HCT survivors, 25% (95% CI, 24% to 27%) in pediatric allogeneic HCT survivors, and 24% (95% CI, 20% to 29%) in pediatric autologous HCT survivors. Factors associated with being lost to follow-up include younger age, nonmalignant disease, public/no insurance (reference: private), residence farther from the tranplantation center, and being unmarried in adult allogeneic HCT survivors; older age and testicular/germ cell tumor (reference: non-Hodgkin lymphoma) in adult autologous HCT survivors; older age, public/no insurance (reference: private), and nonmalignant disease in pediatric allogeneic HCT survivors; and older age in pediatric autologous HCT survivors. Follow-up focusing on minimizing attrition in high-risk groups is needed to ensure surveillance for late effects. (C) 2019 American Society for Transplantation and Cellular Therapy. Published by Elsevier Inc.
Original languageEnglish
Pages (from-to)553-561
Number of pages9
JournalBiology of Blood and Marrow Transplantation
Issue number3
Publication statusPublished - 1 Mar 2020


  • adolescent
  • aya
  • bone marrow transplantation
  • cancer survivors
  • care
  • childhood
  • health
  • intervention
  • lost to follow-up
  • outcomes
  • prevalence
  • stem cell transplantation
  • survivor
  • transition
  • Bone marrow transplantation
  • Stem cell transplantation
  • AYA
  • CARE
  • Survivor
  • Lost to follow-up

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