Lueck, Catherina and Tzalavras, Asterios and Wohlfarth, Philipp and Meedt, Elisabeth and Kiehl, Michael and Turki, Amin T. and Hoeper, Marius M. and Eder, Matthias and Cserna, Julia and Buchtele, Nina and Wolff, Daniel and Schellongowski, Peter and Beutel, Gernot and Liebregts, Tobias (2023) Impact of chronic graft-versus-host-disease on intensive care outcome in allogeneic hematopoietic stem cell recipients. BONE MARROW TRANSPLANTATION, 58 (3). pp. 303-310. ISSN 0268-3369, 1476-5365
Full text not available from this repository. (Request a copy)Abstract
Chronic graft-vs-host-disease (cGvHD) is the most relevant long-term complication after allogeneic stem cell transplantation (HSCT) with major impact on non-relapse mortality, but data on intensive care unit (ICU) outcome are missing. In this retrospective, multicenter study we analyzed 174 adult HSCT recipients with cGvHD requiring intensive care treatment. Skin, pulmonary, liver, and intestinal involvement were present in 76.7%, 47.1%, 38.1% and 24.1%, respectively, and a total of 63.2% had severe cGvHD. Main reasons for ICU admission were respiratory failure (69.7%) and sepsis (34.3%). Hospital- and 3-year OS rates were 51.7% and 28.6%, respectively. Global severity of cGvHD did not impact short- and long-term survival. However, patients with severe liver cGvHD or the overlap subtype had a reduced hospital survival, while severe pulmonary cGvHD was associated with worse long-term survival. In multivariate analysis need for invasive ventilation (HR 1.08 (95% CI 1.02-1.14)) or hemodialysis (HR 1.73 (95% CI 1.14-2.62)) and < 1 year since HSCT (HR 1.56 (95% CI 1.03-2.39)) were independently associated with a poorer survival. While the global severity of cGvHD does not per se affect patients' survival after intensive care treatment, pre-existing severe hepatic, intestinal or pulmonary cGvHD is associated with worse outcomes.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | TRANSPLANTATION RECIPIENTS; PROGNOSIS; REAPPRAISAL; SEVERITY; UNIT; ICU; |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Innere Medizin III (Hämatologie und Internistische Onkologie) |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 05 Mar 2024 11:09 |
| Last Modified: | 05 Mar 2024 11:09 |
| URI: | https://pred.uni-regensburg.de/id/eprint/58369 |
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