Prevalence, Risk Factors, and Complications of Oropharyngeal Dysphagia in Older Patients with Dementia

The prevalence of older patients with dementia and oropharyngeal dysphagia (OD) is rising and management is poor. Our aim was to assess the prevalence, risk factors, and long-term nutritional and respiratory complications during follow-up of OD in older demented patients. We designed a prospective longitudinal quasi-experimental study with 255 patients with dementia. OD was assessed with the Volume-Viscosity Swallowing Test and a geriatric evaluation was performed. OD patients received compensatory treatments based on fluid viscosity and texture modified foods and oral hygiene, and were followed up for 18 months after discharge. Mean age was 83.5 ± 8.0 years and Alzheimer’s disease was the main cause of dementia (52.9%). The prevalence of OD was 85.9%. Up to 82.7% patients with OD required fluid thickening and 93.6% texture modification, with poor compliance. OD patients were older (p < 0.007), had worse functionality (p < 0.0001), poorer nutritional status (p = 0.014), and higher severity of dementia (p < 0.001) than those without OD and showed higher rates of respiratory infections (p = 0.011) and mortality (p = 0.0002) after 18 months follow-up. These results show that OD is very prevalent among patients with dementia and is associated with impaired functionality, malnutrition, respiratory infections, and increased mortality. New nutritional strategies should be developed to increase the compliance and therapeutic effects for this growing population of dysphagic patients.

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The natural course of DSM-IV somatoform disorders and syndromes among adolescents and young adults: a prospective-longitudinal community study

European Psychiatry ◽

10.1016/s0924-9338(02)00686-7 ◽

2002 ◽

Vol 17 (6) ◽

pp. 321-331 ◽

Cited By ~ 81

Author(s):

Roselind Lieb ◽

Petra Zimmermann ◽

Robert H Friis ◽

Michael Höfler ◽

Sven Tholen ◽

...

Keyword(s):

Risk Factors ◽

Substance Use ◽

Young Adults ◽

Somatoform Disorders ◽

Epidemiologic Study ◽

Natural Course ◽

Adolescents And Young Adults ◽

Prospective Longitudinal ◽

Over Time

SummaryObjective.Although somatoform disorders are assumed to be chronic clinical conditions, epidemiological knowledge on their natural course based on representative samples is not available.Method.Data come from a prospective epidemiologic study of adolescents and young adults in Munich, Germany. Respondents’ diagnoses (N = 2548) at baseline and follow-up on average 42 months later are considered. The follow-up incidence, stability as well as selected baseline risk factors (sociodemographics, psychopathology, trauma exposure) for the incidence and stability of somatoform disorders and syndromes are prospectively examined. Diagnostic information was assessed by using the standardized Munich-Composite International Diagnostic Interview (M-CIDI).Results.Over the follow-up period, incidence rate for any of the covered somatoform diagnoses was 25.7%. Stability for the overall group of any somatoform disorder/syndrome was 48%. Female gender, lower social class, the experience of any substance use, anxiety and affective disorder as well as the experience of traumatic sexual and physical threat events predicted new onsets of somatoform conditions, while stability was predicted by being female, prior existing substance use, affective and eating disorders as well as the experience of a serious accident.Conclusions.At least for a substantial proportion of individuals, the overall picture of somatization seems to be relatively stable, but with fluctuation in the symptom picture over time. Being female, the experience of substance use as well as anxiety disorder seem to constitute risk factors for the onset of new somatoform conditions as well as for a stable course over time.

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The Perinatal Adverse events and Special Trends in Cognitive Trajectory (PLASTICITY) - pre-protocol for a prospective longitudinal follow-up cohort study

F1000Research ◽

10.12688/f1000research.2-50.v1 ◽

2013 ◽

Vol 2 ◽

pp. 50 ◽

Cited By ~ 3

Author(s):

Laura Hokkanen ◽

Jyrki Launes ◽

Katarina Michelsson

Keyword(s):

Risk Factors ◽

Social Services ◽

Blood Chemistry ◽

Maternity Hospital ◽

Cognitive Outcomes ◽

Long Term Effects ◽

Aging Studies ◽

Clinical Program ◽

Prospective Longitudinal

Prospective follow-up studies on long term effects of pre- and perinatal adverse conditions in adulthood are rare. We will continue to follow the prospective cohort of initially 1196 subjects with predefined at-delivery risk factors out of 22,359 consecutive deliveries during 1971-74 at a single maternity hospital. The risk cohort and 93 controls have been followed up with a comprehensive clinical program at 5, 9, and 16 years of age and by questionnaire at the age of 30 years. Major medical events known to affect the development and growth of the brain, or cognitive functions and personality have been documented. Here we present a pre-protocol for the project, which we will call PLASTICITY, whose aim is to follow consenting subjects and controls into mid-adulthood and beyond, and to explore how the neonatal risk factors modulate neurodevelopmental and neurodegenerative processes such as learning disabilities, ADHD, aging, early onset mild cognitive impairment and even dementia. Our first focus is on the neurological and cognitive outcomes at age 40 years, using detailed neurological, neuropsychological, neuroimaging, genetic, blood chemistry and registry based methods. Results will be expected to offer information on the risk of neurological, psychiatric, metabolic and other medical consequences as well as the need for health and social services at the brink of middle age, when new degenerative phenomena are known to emerge. The evaluation at age 40 years will serve as a baseline for later aging studies. We welcome all comments and suggestions, which we will apply in finalizing details and inviting collaboration.

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Non-Myeloablative Hematopoietic Stem Cell Transplantation in Older Patients with AML and MDS: Results from the Center for International Blood and Marrow Transplant Research (CIBMTR)

Blood ◽

10.1182/blood.v112.11.346.346 ◽

2008 ◽

Vol 112 (11) ◽

pp. 346-346 ◽

Cited By ~ 12

Author(s):

Brian McClune ◽

Daniel J. Weisdorf ◽

John F. DiPersio ◽

Armand Keating ◽

Tanya L. Pedersen ◽

...

Keyword(s):

Risk Factors ◽

Complete Remission ◽

Cell Transplantation ◽

Older Patients ◽

Univariate Analysis ◽

Hematopoietic Stem ◽

Age Cohorts ◽

Allogeneic Hct ◽

First Complete Remission

Abstract Background: AML and MDS disproportionately affect older-aged individuals. Hematopoietic cell transplantation (HCT) is the best established curative therapy but is generally not offered due to concerns about toxicity and poor outcome. Reduced-intensity conditioning (RIC) regimens have been developed to allow allografting in older patients; however, there is a paucity of data to support transplantation in patients over 65 years of age. Purpose: To better study age as a predictor of outcome, we retrospectively analyzed data reported to the CIBMTR from 1995–2005 among patients receiving RIC HCT for MDS (551 patients) and AML (565 patients) in first complete remission (CR). Patient and Methods: Outcomes analyzed for both disease groups included transplant-related mortality (TRM), engraftment, incidence of acute and chronic graft-versus-host disease (GVHD), leukemia-free (LFS) and overall survival (OS). Patients were stratified according to age cohorts for comparison: 40–54, 54–59, 60–64 and ≥65 years. Results: Clinical characteristics were well matched across age cohorts but notably, most AML patients presented with de novo disease (P=0.001) and received their allograft from a matched related donor (MRD) (P=0.001) with 51% of patients ≥65 years having a MRD. MDS patients more often had unrelated donors (URD), especially in the older cohorts (73% for ≥ 65 years); but donor type was not significantly different between groups. Most patients received peripheral blood (PB) allografts (76–97%), fludarabine-containing regimens for conditioning and cyclosporine-containing regimens for GVHD prophylaxis. Univariate analysis demonstrated no statistically significant differences in TRM across age cohorts and no overall difference in occurrence of acute (31–35% at 100 days) or chronic GVHD (36–53% at 2 years). Relapse rates were similar across all age groups (29–39% at 3 years) (Table). Multivariate analysis revealed no statistically significant impact of age on TRM, relapse, LFS, or OS (all p > 0.4). Disease and status at transplant were significant risk factors for OS/LFS at 1 year while affecting TRM/relapse at 2 years. Performance status and HLA disparity were also significant at 2 years for nearly all outcomes. Conclusion: 1. The outcomes for older adults undergoing allogeneic HCT are not significantly different than for younger adults, even after adjusting for multiple risk factors; 2. Age by itself should not be the limiting factor for proceeding to allogeneic HCT in older patients with AML or MDS; 3. Continued participation in clinical trials should be encouraged to explore strategies that could improve treatment outcome. Univariate probabilities of patients age ≥40 years receiving allogeneic HCT for AML/MDS in first complete remission reported to the CIBMTR, 1995–2005. N 40–54 N 55–60 N 60–64 N >65 AML TRM 220 150 132 63 100 days 11 (7–16)% 6 (3–10)% 13 (8–20)% 10 (4–18)% 1 year 20 (15–26)% 18 (12–24)% 24 (17–33)% 30 (19–42)% Relapse 1 year 27 (21–33)% 34 (26–42)% 31 (23–40)% 22 (12–33)% 3 years 32 (26–39)% 35 (27–43)% 39 (30–49)% 33 (21–46)% LFS 1 year 53 (46–60)% 49 (41–58)% 44 (35–53)% 48 (36–61)% 3 years 43 (36–51)% 41 (32–50)% 27 (19–37)% 34 (22–47)% OS 100 days 84 (78–88)% 92 (87–96)% 83 (76–89)% 89 (80–95)% 1 year 59 (52–65)% 60 (52–68)% 51 (42–60)% 51 (39–64)% 3 years 45 (40–54)% 47 (42–59)% 30 (25–43)% 36(24–49)% Follow-up (months) 37 (2–110) 25 (1–87) 36 (3–96) 29 (3–59) MDS TRM 219 150 127 55 100 days 17 (13–23)% 17 (11–23)% 14 (9–21)% 19 (9–30)% 1 year 31 (24–37)% 33 (25–41)% 32 (24–41)% 34 (22–47)% Relapse 1 year 26 (20–32)% 27 (20–35)% 26 (18–34)% 25 (14–37)% 3 years 29 (23–35)% 29 (22–37)% 31 (23–40)% higher 33 (20–47)% LFS 1 year 43 (36–50)% 40 (32–49)% 43 (34–51)% 42 (29–56)% 3 years 36 (29–43)% 27 (–2035)% 29 (21–39)% 23 (12–38)% OS 100 days 77 (71–82)% 77 (70–83)% 81 (74–87)% 76 (64–87)% 1 year 50 (43–56)% 46 (38–54)% 53 (44–62)% 48 (35–61)% 3 years 39 (32–46)% 29 (22–37)% 30 (21–40)% 29 (17–43)% Follow-up (months) 36 (2–86) 40 (3–86) 35 (3–68) 36 (3–85)

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074 First seizures in emergency department vs ward: study in an elderly population

Journal of Neurology Neurosurgery & Psychiatry ◽

10.1136/jnnp-2018-anzan.73 ◽

2018 ◽

Vol 89 (6) ◽

pp. A30.2-A30

Author(s):

Emma Foster ◽

Sarah Holper ◽

Patrick Kwan

Keyword(s):

Risk Factors ◽

Older Patients ◽

Management Strategies ◽

Individual Risk ◽

Not Otherwise Specified ◽

Therapeutic Decisions ◽

Icd 10 ◽

Symptomatic Seizures ◽

Acute Disturbance

IntroductionSeizures are common in hospitals, both as presentations to Emergency Departments (ED) and as hospital onset seizures (HOS), occurring in ward patients hospitalised for non-seizure reasons. Prompt identification of seizure aetiology is important, as it affects prognosis and management choices. Acute symptomatic seizures due to acute disturbance of brain function have a far lower risk of recurrence compared to unprovoked seizures. Timely investigations and specialist review assesses individual risk for seizure recurrence, which then guides therapeutic decisions including antiepileptic drug (AED) use. This study includes a larger proportion of older patients than usually reported, and as such, provides important insights into seizure aetiology and management strategies in this demographic.MethodsThis retrospective survey of medical charts reviewed patients aged 18 or over with a hospital separation coded as ICD-10 G40 (Epilepsy), G41 (Status epilepticus), or R56.9 (convulsions not otherwise specified), presenting between 1 January 2008 through 30 November 2016, to a large metropolitan private hospital. 97 episodes of ED attendance for first seizure and 54 episodes of HOS were identified.ResultsMedian age was 70 years in ED-cohort and 80.5 years in HOS-cohort. Symptomatic seizure risk factors were identified in 62.89% of ED-cohort and 83.33% of HOS-cohort, including exposure to known epileptogenic drugs in 38.89% of HOS-cohort. Antiepileptic drugs (AEDs) were prescribed on discharge to 74.23% of ED-cohort and 81.48% of HOS-cohort, but far fewer had scheduled Neurologist review (58.76% of ED- and 35.19% of HOS-cohorts).ConclusionThis study includes a larger proportion of older patients than usually reported, and as such, provides important insights into seizure aetiology and management strategies in this demographic. This includes caution when prescribing known epileptogenic drugs; mindful prescription of AED on discharge; and ensuring adequate Neurologist follow-up to monitor further seizure activity, addressing seizure risk factors, and ongoing need for AED.

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Assessment of chronic bronchitis and risk factors in young adults: Results from BAMSE

European Respiratory Journal ◽

10.1183/13993003.02120-2020 ◽

2020 ◽

pp. 2002120

Author(s):

Gang Wang ◽

Jenny Hallberg ◽

Petra Um Bergström ◽

Christer Janson ◽

Göran Pershagen ◽

...

Keyword(s):

Risk Factors ◽

Air Pollution ◽

Young Adults ◽

Chronic Bronchitis ◽

Breast Feeding ◽

Early Life ◽

Respiratory Infections ◽

Mucus Production ◽

Exclusive Breast Feeding

BackgroundChronic bronchitis is associated with substantial morbidity among elderly adults, but little is known about its prevalence and risk factors in young adults. Our aim was to assess the prevalence and early life risk factors for chronic bronchitis in young adults.MethodsQuestionnaire data and clinical measures from the 24-year follow-up of the Swedish BAMSE cohort were used. We assessed chronic bronchitis (CB) as the combination of cough and mucus production in the morning during winter. Environmental and clinical data from birth and onwards were used for analyses of risk factors.ResultsAt the 24-year follow-up, 75% (n=3064) participants completed the questionnaire and 2030 performed spirometry. The overall prevalence of CB was 5.5% (n=158) with similar estimates in males and females. Forty-nine percent of CB cases experienced more than 3 self-reported respiratory infections in the last year compared to 18% in non-CB subjects (p<0.001), and 37% of cases were current smokers (versus 19%). Statistically significant lower post-FEV1/FVC were observed in CB compared to non-CB subjects (mean z-score −0.06 versus 0.13, p=0.027). Daily smoking (adjusted Odds Ratio, aOR=3.85, p<0.001), air pollution exposure (black carbon during ages 1–4 years old, aOR=1.71 per 1 μg·m3 increase, p=0.009) and exclusive breast-feeding during four months or more (aOR=0.66, p=0.044) were associated with CB.ConclusionChronic bronchitis in young adults is associated with recurrent respiratory infections. Besides smoking, our results support role of early life exposures, such as air pollution and exclusive breast-feeding, for respiratory health later in life.

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Incidence and risk factors for respiratory tract bacterial colonization and infection in lung transplant recipients

European Journal of Clinical Microbiology & Infectious Diseases ◽

10.1007/s10096-021-04153-1 ◽

2021 ◽

Author(s):

L. Paglicci ◽

V. Borgo ◽

N. Lanzarone ◽

M. Fabbiani ◽

C. Cassol ◽

...

Keyword(s):

Risk Factors ◽

Lower Risk ◽

Lung Transplant ◽

Respiratory Infections ◽

Heart Diseases ◽

Bacterial Colonization ◽

Transplant Recipients ◽

Infectious Risk ◽

Lung Transplant Recipients

AbstractTo evaluate incidence of and risk factors for respiratory bacterial colonization and infections within 30 days from lung transplantation (LT). We retrospectively analyzed microbiological and clinical data from 94 patients transplanted for indications other than cystic fibrosis, focusing on the occurrence of bacterial respiratory colonization or infection during 1 month of follow-up after LT. Thirty-three percent of patients developed lower respiratory bacterial colonization. Bilateral LT and chronic heart diseases were independently associated to a higher risk of overall bacterial colonization. Peptic diseases conferred a higher risk of multi-drug resistant (MDR) colonization, while longer duration of aerosol prophylaxis was associated with a lower risk. Overall, 35% of lung recipients developed bacterial pneumonia. COPD (when compared to idiopathic pulmonary fibrosis, IPF) and higher BMI were associated to a lower risk of bacterial infection. A higher risk of MDR infection was observed in IPF and in patients with pre-transplant colonization and infections. The risk of post-LT respiratory infections could be stratified by considering several factors (indication for LT, type of LT, presence of certain comorbidities, and microbiologic assessment before LT). A wider use of early nebulized therapies could be useful to prevent MDR colonization, thus potentially lowering infectious risk.

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Post-traumatic stress disorder symptoms after acute lung injury: a 2-year prospective longitudinal study

Psychological Medicine ◽

10.1017/s0033291713000214 ◽

2013 ◽

Vol 43 (12) ◽

pp. 2657-2671 ◽

Cited By ~ 89

Author(s):

O. J. Bienvenu ◽

J. Gellar ◽

B. M. Althouse ◽

E. Colantuoni ◽

T. Sricharoenchai ◽

...

Keyword(s):

Risk Factors ◽

Intensive Care ◽

Post Traumatic Stress Disorder ◽

Traumatic Stress ◽

Stress Disorder ◽

Ptsd Symptoms ◽

Post Traumatic Stress ◽

Post Traumatic ◽

Prospective Longitudinal

BackgroundSurvivors of critical illnesses often have clinically significant post-traumatic stress disorder (PTSD) symptoms. This study describes the 2-year prevalence and duration of PTSD symptoms after acute lung injury (ALI), and examines patient baseline and critical illness/intensive care-related risk factors.MethodThis prospective, longitudinal cohort study recruited patients from 13 intensive care units (ICUs) in four hospitals, with follow-up 3, 6, 12 and 24 months after ALI onset. The outcome of interest was an Impact of Events Scale – Revised (IES-R) mean score ⩾1.6 (‘PTSD symptoms’).ResultsDuring the 2-year follow-up, 66/186 patients (35%) had PTSD symptoms, with the greatest prevalence by the 3-month follow-up. Fifty-six patients with post-ALI PTSD symptoms survived to the 24-month follow-up, and 35 (62%) of these had PTSD symptoms at the 24-month follow-up; 50% had taken psychiatric medications and 40% had seen a psychiatrist since hospital discharge. Risk/protective factors for PTSD symptoms were pre-ALI depression [hazard odds ratio (OR) 1.96, 95% confidence interval (CI) 1.06–3.64], ICU length of stay (for a doubling of days, OR 1.39, 95% CI 1.06–1.83), proportion of ICU days with sepsis (per decile, OR 1.08, 95% CI 1.00–1.16), high ICU opiate doses (mean morphine equivalent ⩾100 mg/day, OR 2.13, 95% CI 1.02–4.42) and proportion of ICU days on opiates (per decile, OR 0.83, 95% CI 0.74–0.94) or corticosteroids (per decile, OR 0.91, 95% CI 0.84–0.99).ConclusionsPTSD symptoms are common, long-lasting and associated with psychiatric treatment during the first 2 years after ALI. Risk factors include pre-ALI depression, durations of stay and sepsis in the ICU, and administration of high-dose opiates in the ICU. Protective factors include durations of opiate and corticosteroid administration in the ICU.

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Risk factors for orofacial and limbtruncal tardive dyskinesia in older patients: a prospective longitudinal study

Psychopharmacology ◽

10.1007/bf02246639 ◽

1996 ◽

Vol 123 (4) ◽

pp. 307-314 ◽

Cited By ~ 19

Author(s):

J. S. Paulsen ◽

M. P. Caligiuri ◽

B. Palmer ◽

L. A. McAdams ◽

D. V. Jeste

Keyword(s):

Risk Factors ◽

Longitudinal Study ◽

Tardive Dyskinesia ◽

Older Patients ◽

Prospective Longitudinal Study ◽

Prospective Longitudinal

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Oropharyngeal dysphagia in older patients with hip fracture

Age and Ageing ◽

10.1093/ageing/afab032 ◽

2021 ◽

Author(s):

Jesús Mateos-Nozal ◽

Elisabet Sanchez Garcia ◽

Estela Romero Rodríguez ◽

Alfonso J Cruz-Jentoft

Keyword(s):

Hip Fracture ◽

Geriatric Assessment ◽

Older Patients ◽

Oropharyngeal Dysphagia ◽

Multivariate Logistic Regression Analysis ◽

University Hospital ◽

Post Surgery ◽

Volume Viscosity ◽

Fracture Management ◽

A Prospective Study

Abstract Background oropharyngeal dysphagia (OD) and hip fracture are common problems in older patients, both associated with important complications. Objective the aim of this study was to measure the prevalence and identify the main risk factors of dysphagia in older patients with hip fracture. Design a prospective study in an orthogeriatric unit of a university hospital over 10 months. Methods a total of 320 patients (mean age 86.2 years, 73.4% women) were assessed for dysphagia within 72 hours post-surgery using the Volume-Viscosity Swallow Test. Geriatric assessment, hip fracture management and complications were examined to determine their relationship with the presence of OD. Results dysphagia was present in 176 (55%) patients. Multivariate logistic regression analysis showed that the presence of delirium during hospitalization and the inability to perform instrumental activities of daily living before admission were associated with OD. Conclusions the prevalence of OD is high in hip fracture patients. Objective dysphagia assessment should be routinely included as part of the geriatric assessment of such patients.

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High Incidence of Secondary Malignancies after Reduced Intensity Allo-SCT: Results of a Single-Center Study with Extended Follow-up

Blood ◽

10.1182/blood.v126.23.4353.4353 ◽

2015 ◽

Vol 126 (23) ◽

pp. 4353-4353

Author(s):

Jeremy Delage ◽

Stephane Vigouroux ◽

Reza Tabrizi ◽

Catherine Mohr ◽

Pascal Turlure ◽

...

Keyword(s):

Risk Factors ◽

Stem Cell ◽

Older Patients ◽

Secondary Malignancies ◽

Single Center ◽

Hematopoietic Stem ◽

High Incidence ◽

Disease Free ◽

Reduced Intensity

Abstract Allogeneic hematopoietic stem cell transplantation (HCT) is a potentially curative treatment for malignant and non-malignant diseases. The late complications in the myeloablative setting, including secondary malignancies (SM), have been reported in several studies. For example, the CIBMTR reported a 10-years cumulative incidence (CI) of 1%. The recent development of reduced intensity conditioning (RIC) for older patients has dramatically increased the number of HCT. Because they are typically performed in older patients, the analysis of post-transplant SM in this population is of particular interest. However, reported data are scarce in this specific population in the RIC setting. As a consequence, we performed a single center retrospective study to assess the risk of SM with extended follow-up in patients transplanted after a RIC regimen. Patients transplanted at our center for a hematological malignancy after a RIC regimen between 01/01/2000 and 12/31/2012 were screened. The analysis was performed in the subgroup of patients alive and disease-free 2 years after transplant. Probabilities of overall survival (OS) were calculated from using the Kaplan-Meier estimate. Non-relapse mortality (NRM) included all causes of death without prior relapse, occurring at any time after transplant. All probabilities were calculated from the date of transplantation. CI curves were used for NRM and SM in a competing risk setting with relapse as a competing event for NRM and death for SM. The analysis of risk factors for SM was performed using the Fine and Gray model. Five hundred and six patients were transplanted after a RIC regimen during the period of study. Among them, 223 were alive and disease-free at 2 years and thus included in the study. The median follow up was 73 months (24.3; 173). The median age was 55 years (18; 67). The characteristics of patients, diseases and transplants are summarized in Table 1. The 5-year OS was 85.3 % (CI 95%: 80.3 - 90.6) (Figure1). The 5-year OS in the no SM vs SM groups were 85% vs 83.5% while the 10-year OS in the same groups were 79.4% vs 33.3%, respectively, (p=0.0052). Thirty-eight patients died: 11 of relapse, 7 of SM, 15 of chronic GVHD or infection, 2 of vascular complications, 2 of unknown causes and one of suicide. Twenty-five patients developed a SM (excluding non-melanoma skin cancer) at a median time of 63.7 months (13.57; 172) after transplant. The 5 and 10-year CI of SM were 6.4%±1.7% and 18,7%±3.9%, respectively (Figure 2). The SM were distributed as follow: lung cancer (n=5), squamous cell carcinoma (1 throat, 1 tongue and 1 sinus), oesophageal cancer (n=3), colon cancer (n=2), Hodgkin lymphoma (n=2), bladder cancer (n=2), prostate cancer (n=2), melanoma (n=1), ovarian cancer (n=1), endometrial cancer (n=1), sarcoma (n=1), glioblastoma (n=1) and an unknown primary cancer (n=1). Multivariate analysis identified CMV seropositivity of donor and/or recipient (HR 4,4, p=0,016), non-sibling donor (HR 2,7, p=0,01) and a female donor for a male recipient (HR 2,7, p=0,012) as risk factors for SM. In conclusion, we report a high incidence of SM as a late complication of HCT in patients with a median age of 55 years after an extended follow-up. This result strongly suggest that older patients should be carefully followed for a prolonged period after HCT and that attention must be paid to usual recommended screening tests and classical risk factors like tobacco and alcohol. Table 1. Characteristics of patients, diseases and transplants (n=223) Value Median age (years) (range) 55 (18; 67) Gender MaleFemale 133 (60%)90 (40%) Diseases AMLALLMDSCMLMPDNHLHLCLLMMSAA 89 (40%)12 (5%)18 (8%)2 (1%)2 (1%)38 (17%)9 (4%)11 (5%)29 (13%)13 (6%) Status at transplant Early stageAdvance stage 106 (48%)117 (52%) Prior autologous transplantation 85 (38%) Conditioning regimen Fluda + Bu 2 daysTBI 2Gy + FludaFluda + Cy + TBI 2 GyCy + TBI 2GyOther 133 (60%)33 (15%)24 (11%)12 (5%)19 (9%) Source of stem cell BMPBSCCB 20 (9%)179 (80%)24 (11%) Rabbit ATG ATGNo ATG 156 (70%)67 (30%) Donor HLA-identical siblingMatched related donorMatched unrelated donorCord blood 105 (47%)69 (31%)25 (11%)24 (11%) Prophylaxis of GVHD CsACsA + MTXCsA + MMF 70 (31%)82 (37%)71 (32%) Period of transplant 2000-062007-12 87 (39%)136 (61%) Disclosures Milpied: Celgene: Honoraria, Research Funding.

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