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- Title
Improved intensive care unit survival for critically ill allogeneic haematopoietic stem cell transplant recipients following reduced intensity conditioning.
- Authors
Townsend, William M.; Holroyd, Ailsa; Pearce, Rachel; Mackinnon, Stephen; Naik, Prakesh; Goldstone, Anthony H.; Linch, David C.; Peggs, Karl S.; Thomson, Kirsty J.; Singer, Mervyn; Howell, David C. J.; Morris, Emma C.
- Abstract
The use of allogeneic haematopoietic stem cell transplantation (Allo- HSCT) is a standard treatment option for many patients with haematological malignancies. Historically, patients requiring intensive care unit ( ICU) admission for transplant-related toxicities have fared extremely poorly, with high ICU mortality rates. Little is known about the impact of reduced intensity Allo- HSCT conditioning regimens in older patients on the ICU and subsequent long-term outcomes. A retrospective analysis of data collected from 164 consecutive Allo- HSCT recipients admitted to ICU for a total of 213 admissions, at a single centre over an 11·5-year study period was performed. Follow-up was recorded until 31 March 2011. Autologous HSCT recipients were excluded. In this study we report favourable ICU survival following Allo- HSCT and, for the first time, demonstrate significantly better survival for patients who underwent Allo- HSCT with reduced intensity conditioning compared to those treated with myeloablative conditioning regimens. In addition, we identified the need for ventilation (invasive or non-invasive) as an independently significant adverse factor affecting short-term ICU outcome. For patients surviving ICU admission, subsequent long-term overall survival was excellent; 61% and 51% at 1 and 5 years, respectively. Reduced intensity Allo- HSCT patients admitted to ICU with critical illness have improved survival compared to myeloablative Allo- HSCT recipients.
- Subjects
HEMATOPOIETIC stem cell transplantation; GRAFT versus host disease; INTENSIVE care units; CRITICALLY ill; HEMATOLOGICAL oncology; HEALTH outcome assessment
- Publication
British Journal of Haematology, 2013, Vol 161, Issue 4, p578
- ISSN
0007-1048
- Publication type
Article
- DOI
10.1111/bjh.12294