What are late issues after HCT?

Two years after BMT, most common problem? Relapse Non-relapse events Second malignancies: 2-6%, ⇧ in FA patients, assoc. c XRT Growth failure: Rare, associated with TBI + CNS XRT Endocrine issues: Hypothyroidism, Gonadal failure Pre-HCT Rx and GVHD contribute significantly to late effects Cardiac related to XRT and anthracylines GVHD effect on lungs, QoL Emerging Evidence of TBI effect on children < 3 at HCT