Long-term outcomes in patients treated in the intensive care unit after hematopoietic stem cell transplantation

Makoto Nakamura, Nobuharu Fujii, Kazuyoshi Shimizu, Shuntaro Ikegawa, Keisuke Seike, Tomoko Inomata, Yasuhisa Sando, Keiko Fujii, Hisakazu Nishimori, Ken-ichi Matsuoka, Hiroshi Morimatsu, Yoshinobu Maeda

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2 Citations (Scopus)

Abstract

The number of patients who are successfully discharged from the intensive care unit (ICU) after hematopoietic stem cell transplantation (HSCT) remains limited. Most previous studies have evaluated short-term outcomes using ICU mortality; there have been comparatively fewer reports of long-term outcomes. We retrospectively analyzed 39 HSCT patients admitted to the ICU for the first time between April 2008 and July 2014. Performance status was evaluated in four long-term survivors in July 2016. Median age at ICU admission was 54 years (range 30–68). In total, 33 patients (70.2%) required mechanical ventilation and 31 patients (66%) required dialysis. The median OS from first ICU admission was 41 days (95% confidence interval [CI]: 22–64) and the 1-year survival rate was 12.8% (95% CI 4.7–25.2). No statistically significant factors were associated with short-term outcomes. Among long-term outcomes, a second or subsequent HSCT and neutropenia at ICU admission were significant risk factors. Four of 10 ICU survivors have survived with good performance status for a median of 1994 (1203–2633) days. Our results suggest that the number of prior transplants and neutropenia at ICU admission may influence OS.

Original languageEnglish
JournalInternational Journal of Hematology
DOIs
Publication statusAccepted/In press - Jan 1 2018

Fingerprint

Hematopoietic Stem Cell Transplantation
Intensive Care Units
Neutropenia
Survivors
Confidence Intervals
Artificial Respiration
Dialysis
Survival Rate
Transplants
Mortality

Keywords

  • Hematopoietic stem cell transplantation
  • Intensive care unit
  • Long-term outcomes
  • Neutropenia
  • Number of prior transplants

ASJC Scopus subject areas

  • Hematology

Cite this

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title = "Long-term outcomes in patients treated in the intensive care unit after hematopoietic stem cell transplantation",
abstract = "The number of patients who are successfully discharged from the intensive care unit (ICU) after hematopoietic stem cell transplantation (HSCT) remains limited. Most previous studies have evaluated short-term outcomes using ICU mortality; there have been comparatively fewer reports of long-term outcomes. We retrospectively analyzed 39 HSCT patients admitted to the ICU for the first time between April 2008 and July 2014. Performance status was evaluated in four long-term survivors in July 2016. Median age at ICU admission was 54 years (range 30–68). In total, 33 patients (70.2{\%}) required mechanical ventilation and 31 patients (66{\%}) required dialysis. The median OS from first ICU admission was 41 days (95{\%} confidence interval [CI]: 22–64) and the 1-year survival rate was 12.8{\%} (95{\%} CI 4.7–25.2). No statistically significant factors were associated with short-term outcomes. Among long-term outcomes, a second or subsequent HSCT and neutropenia at ICU admission were significant risk factors. Four of 10 ICU survivors have survived with good performance status for a median of 1994 (1203–2633) days. Our results suggest that the number of prior transplants and neutropenia at ICU admission may influence OS.",
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author = "Makoto Nakamura and Nobuharu Fujii and Kazuyoshi Shimizu and Shuntaro Ikegawa and Keisuke Seike and Tomoko Inomata and Yasuhisa Sando and Keiko Fujii and Hisakazu Nishimori and Ken-ichi Matsuoka and Hiroshi Morimatsu and Yoshinobu Maeda",
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T1 - Long-term outcomes in patients treated in the intensive care unit after hematopoietic stem cell transplantation

AU - Nakamura, Makoto

AU - Fujii, Nobuharu

AU - Shimizu, Kazuyoshi

AU - Ikegawa, Shuntaro

AU - Seike, Keisuke

AU - Inomata, Tomoko

AU - Sando, Yasuhisa

AU - Fujii, Keiko

AU - Nishimori, Hisakazu

AU - Matsuoka, Ken-ichi

AU - Morimatsu, Hiroshi

AU - Maeda, Yoshinobu

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AB - The number of patients who are successfully discharged from the intensive care unit (ICU) after hematopoietic stem cell transplantation (HSCT) remains limited. Most previous studies have evaluated short-term outcomes using ICU mortality; there have been comparatively fewer reports of long-term outcomes. We retrospectively analyzed 39 HSCT patients admitted to the ICU for the first time between April 2008 and July 2014. Performance status was evaluated in four long-term survivors in July 2016. Median age at ICU admission was 54 years (range 30–68). In total, 33 patients (70.2%) required mechanical ventilation and 31 patients (66%) required dialysis. The median OS from first ICU admission was 41 days (95% confidence interval [CI]: 22–64) and the 1-year survival rate was 12.8% (95% CI 4.7–25.2). No statistically significant factors were associated with short-term outcomes. Among long-term outcomes, a second or subsequent HSCT and neutropenia at ICU admission were significant risk factors. Four of 10 ICU survivors have survived with good performance status for a median of 1994 (1203–2633) days. Our results suggest that the number of prior transplants and neutropenia at ICU admission may influence OS.

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