Death after hematopoietic stem cell transplantation: changes over calendar year time, infections and associated factors.
- Styczyński J Pediatric Hematology and Oncology, Collegium Medicum, Nicolaus Copernicus University Torun, Bydgoszcz, Poland. jstyczynski@cm.umk.pl.
- Tridello G Policlinico G.B. Rossi, Verona, Italy.
- Koster L EBMT Data Office, Leiden, The Netherlands.
- Iacobelli S Università di Roma "Tor Vergata", Roma, Italy.
- van Biezen A EBMT Data Office, Leiden, The Netherlands.
- van der Werf S EBMT Data Office, Leiden, The Netherlands.
- Mikulska M Division of Infectious Diseases, University of Genoa (DISSAL) and Ospedale Policlinico San Martino, Genoa, Italy.
- Gil L Medical University, Poznań, Poland.
- Cordonnier C Hôpital Henri Mondor, Assistance Publique-Hopitaux de Paris (AP-HP) and Paris-Est-Créteil University, Creteil, France.
- Ljungman P Karolinska University Hospital, and Karolinska Institutet Stockholm, Stockholm, Sweden.
- Averbuch D Hadassah University Hospital, Jerusalem, Israel.
- Cesaro S Policlinico G.B. Rossi, Verona, Italy.
- de la Camara R Hospital de la Princesa, Madrid, Spain.
- Baldomero H EBMT Activity Survey Office, Hematology, Department of Medicine, University Hospital, Basel, Switzerland.
- Bader P Universitätsklinikum Frankfurt, Goethe-Universität, Frankfurt am Main, Germany.
- Basak G Department of Hematology, Oncology and Internal Medicine, Medical University of Warsaw, Warsaw, Poland.
- Bonini C Università Vita-Salute San Raffaele, Milan, Italy.
- Duarte R Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain.
- Dufour C Hematology Unit, G. Gaslini Children's Institute, Genova, Italy.
- Kuball J Department of Haematology, University Medical Centre, Utrecht, The Netherlands.
- Lankester A Leiden University Hospital, Leiden, The Netherlands.
- Montoto S Department of Haemato-oncology, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK.
- Nagler A Chaim Sheba Medical Center, Tel-Hashomer, Israel.
- Snowden JA Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
- Kröger N Department of Stem Cell Transplantation, University Hospital Eppendorf, Hamburg, Germany.
- Mohty M Department of Hematology, Hospital Saint Antoine, Paris, France.
- Gratwohl A Hematology, Medical Faculty, University of Basel, Basel, Switzerland.
- 2019-08-29
Published in:
- Bone marrow transplantation. - 2020
English
Information on incidence, and factors associated with mortality is a prerequisite to improve outcome after hematopoietic stem cell transplantation (HSCT). Therefore, 55'668 deaths in 114'491 patients with HSCT (83.7% allogeneic) for leukemia were investigated in a landmark analysis for causes of death at day 30 (very early), day 100 (early), at 1 year (intermediate) and at 5 years (late). Mortality from all causes decreased from cohort 1 (1980-2001) to cohort 2 (2002-2015) in all post-transplant phases after autologous HSCT. After allogeneic HSCT, mortality from infections, GVHD, and toxicity decreased up to 1 year, increased at 5 years; deaths from relapse increased in all post-transplant phases. Infections of unknown origin were the main cause of infectious deaths. Lethal bacterial and fungal infections decreased from cohort 1 to cohort 2, not unknown or mixed infections. Infectious deaths were associated with patient-, disease-, donor type, stem cell source, center, and country- related factors. Their impact varied over the post-transplant phases. Transplant centres have successfully managed to reduce death after HSCT in the early and intermediate post-transplant phases, and have identified risk factors. Late post-transplant care could be improved by focus on groups at risk and better identification of infections of "unknown origin".
- Language
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- English
- Open access status
- hybrid
- Identifiers
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- DOI 10.1038/s41409-019-0624-z
- PMID 31455899
- Persistent URL
- https://sonar.ch/global/documents/92776
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