Evaluation of risk factors for and subsequent mortality from poor graft function (PGF) post allogeneic stem cell transplantation.
Ashvind A PrabahranRachel KoldejLynette CheeEric WongDavid RitchiePublished in: Leukemia & lymphoma (2021)
Poor Graft Function (PGF) is defined by multi-lineage cytopenias with complete donor chimerism post allogeneic transplantation, Risk factors for and subsequent mortality from PGF were assessed in our transplant cohort. Non-sibling donor [OR 1.97; 95% CI 1.02-3.70], ICU admission [OR 5.28; 95% CI 2.29-11.88] or blood culture positivity within the first 30 days [OR 1.67; 95% CI 1.07-2.62], grade III-IV acute graft vs host disease (GVHD) [OR 4.082; 95% CI 2.31-7.16] and CMV viremia [OR 2.43; 95% CI 1.53-3.88] and were significantly associated with development of PGF. PGF patients without count recovery had a 2 year OS of 6%. Severe GVHD, thrombocytopenia and anemia portended inferior survival and were used to develop a prognostic score for mortality from PGF. This analysis identifies risk factors predictive of PGF and poor survival in those without recovery.
Keyphrases
- stem cell transplantation
- risk factors
- high dose
- cardiovascular events
- end stage renal disease
- chronic kidney disease
- allogeneic hematopoietic stem cell transplantation
- emergency department
- ejection fraction
- bone marrow
- newly diagnosed
- intensive care unit
- early onset
- dna methylation
- stem cells
- gene expression
- peripheral blood
- prognostic factors
- respiratory failure
- hepatitis b virus
- acute myeloid leukemia
- hematopoietic stem cell
- type diabetes