Improved intensive care unit survival for critically ill allogeneic haematopoietic stem cell transplant recipients following reduced intensity conditioning. (18th March 2013)

• Record Type: Journal Article
• 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.
• Is Part Of: British journal of haematology. Volume 161:Number 4(2013:May)
• Page Start: 578
• Page End: 586
• Publication Date: 2013-03-18
• Subjects: Hematology -- Periodicals; Blood -- Diseases -- Periodicals; 616.15
• DOI: 10.1111/bjh.12294
• Languages: English
• ISSNs: 0007-1048

Abstract

<abstract abstract-type="main" xml:lang="en" id="bjh12294-abs-0001"> <title>Summary</title> <p>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.</p> </abstract>