ISSN 1866-8836
Клеточная терапия и трансплантация

PС-05. Outcomes in patients with life-threatening complications treated in the intensive care unit after allogeneic hematopoietic stem cell transplantation

Antonina E. Shchekina, Gennadii M. Galstyan, Mikhail Yu. Drokov

National Research Center for Hematology, Moscow, Russia

Contact: Antonina E. Shchekina, phone: +7(916) 330 9610, e-mail: shekina_ae@mail.ru

doi 10.18620/ctt-1866-8836-2020-9-3-1-152

Summary

Introduction

10 to 57% of patients undergoing allogeneic hematopoietic stem cell transplantation (allo-HSCT) later require intensive care management for a life-threatening complication [1], which is a factor of poor prognosis [2]. Our purpose was to investigate the outcomes of various life-threatening complications in allo-HSCT patients.

Patients and methods

Retrospective review of 144 critically ill allo-HSCT patients (table 1) admitted to the intensive care unit (ICU) of National Research Center for Hematology from 2012 to 2020. The results were analyzed by IBM SPSS v.23 (USA). Overall survival (OS) was estimated using the Kaplan–Meier method with Log-rank test. A p-value of <0.05 was considered statistically significant.

Table 1. Characteristics of allo-HSCT patients admitted to the ICU

Shchekina-tab01.jpg

Results

The overall survival of critically ill allo-HSCT patients admitted to the ICU was 20%. The cause-related overall survival is shown in the table 2. The highest OS (41%) was registered in the patients with sepsis. The OS for acute respiratory failure (ARF) was 4%. The worst OS (0%) was observed in critically ill patients, due to graft-versus-host disease (GvHD) of gastrointestinal tract and pulmonary GvHD (Fig. 1).

Shchekina-fig01.jpg

Figure 1. The cause-related overall survival of allo-HSCT patients admitted to the ICU

Allo-HSCT, allogeneic hematopoietic stem cell transplantation; ICU, intensive care unit; ARF, acute respiratory failure; OS, overall survival

Table 2. Outcomes of allo-HSCT patients with different life-threatening complications

Shchekina-tab02.jpg

ARF, acute respiratory failure; GvHD, graft-versus-host disease; allo-HSCT, allogeneic hematopoietic stem cell transplantation; ICU, intensive care unit. *Steroid-refractory forms of GvHD

Conclusions

It was assessed that the OS rate depends on the causes of life-threatening complications. The worst prognosis among patients after transplantation was observed in steroid-refractory forms of GvHD. Infectious conditions that proceed without respiratory failure were the most curable complications.

It was assessed that the OS rate depends on the causes of life-threatening complications. The worst prognosis among patients after transplantation was observed in steroid-refractory forms of GvHD. Infectious conditions that proceed without respiratory failure were the most curable complications.

References

1. Saillard C et al (2018) Critically ill allogenic HSCT patients in the intensive care unit: a systematic review and meta-analysis of prognostic factors of mortality. Bone Marrow Transplant. 53:1233-1241.
2. Lindgaard SC (2016) Prognosis of Allogeneic Haematopoietic Stem Cell Recipients Admitted to the Intensive Care Unit: A Retrospective, Single-Centre Study. Acta Haematol 135:72-78.

Keywords

Allogeneic HSCT, life-threatening complications, intensive care unit.



Volume 9, Number 3
09/30/2020

Download PDF version

doi 10.18620/ctt-1866-8836-2020-9-3-1-152

Back to the list