Major complications according to therapeutic exposure
| Therapeutic exposure . | Long-term complications . |
|---|---|
| TBI | Metabolic syndrome (lipodystrophy-like features), and overt metabolic and cardiovascular complications (myocardial infarction, stroke, diabetes), osteonecrosis, low bone mineral density, severe growth retardation, hypothyroidism, secondary malignant neoplasms and meningioma, ovarian/testicular hormone deficiency, reduced ovarian follicular pool, impaired spermatogenesis, uterine toxicity, cataract, chronic renal insufficiency |
| High-dose alkylating agents (primarily busulfan-based conditioning) | Complications overlap with TBI (notably fertility defects); less frequent metabolic syndrome, secondary malignant neoplasms and meningioma, growth retardation and cataracts; increased risk of persistent partial alopecia |
| HSCT (any conditioning regimen) | Bronchiolitis obliterans, chronic graft-versus-host disease |
| CNS irradiation | Metabolic syndrome, obesity, endocrine complications (central hypothyroidism, gonadotropin deficiency, precocious puberty), growth retardation, neurocognitive defects, secondary malignant neoplasms and meningioma, cataracts |
| Anthracyclines and anthraquinones | Anthracycline-related cardiomyopathy |
| High-dose corticosteroids | Osteonecrosis, cataracts |
| Therapeutic exposure . | Long-term complications . |
|---|---|
| TBI | Metabolic syndrome (lipodystrophy-like features), and overt metabolic and cardiovascular complications (myocardial infarction, stroke, diabetes), osteonecrosis, low bone mineral density, severe growth retardation, hypothyroidism, secondary malignant neoplasms and meningioma, ovarian/testicular hormone deficiency, reduced ovarian follicular pool, impaired spermatogenesis, uterine toxicity, cataract, chronic renal insufficiency |
| High-dose alkylating agents (primarily busulfan-based conditioning) | Complications overlap with TBI (notably fertility defects); less frequent metabolic syndrome, secondary malignant neoplasms and meningioma, growth retardation and cataracts; increased risk of persistent partial alopecia |
| HSCT (any conditioning regimen) | Bronchiolitis obliterans, chronic graft-versus-host disease |
| CNS irradiation | Metabolic syndrome, obesity, endocrine complications (central hypothyroidism, gonadotropin deficiency, precocious puberty), growth retardation, neurocognitive defects, secondary malignant neoplasms and meningioma, cataracts |
| Anthracyclines and anthraquinones | Anthracycline-related cardiomyopathy |
| High-dose corticosteroids | Osteonecrosis, cataracts |