In‐hospital mortality of hematopoietic stem cell transplantation among children with nonmalignancies: A nationwide study in the United States from 2000 to 2012. Issue 6 (10th February 2019)

• Record Type: Journal Article
• Authors: Takahashi, Takuto; Pereda, Maria A.; Bala, Natasha; Nagarajan, Sairaman
• Is Part Of: Pediatric blood & cancer. Volume 66:Issue 6(2019)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2019-02-10
• Subjects: in‐hospital mortality -- kids' inpatient database -- nonmalignant -- posttransplant complication -- stem cell transplantation; Tumors in children -- Periodicals; Blood -- Diseases -- Periodicals; Cancer in children -- Periodicals; 618.92
• DOI: 10.1002/pbc.27626
• Languages: English
• ISSNs: 1545-5009

Abstract

Abstract: Background: Hematopoietic stem cell transplant (HSCT) can cure or alleviate a wide range of nonmalignant childhood conditions. However, few studies have examined longitudinal national trends of frequency or short‐term complications of HSCT before 2006 when an HSCT became a reportable procedure by US law. By using a US nationally representative database, we conducted nationwide longitudinal analyses on demographics, in‐hospital mortality, and short‐term complications in nonmalignant HSCT from 2000 to 2012. Procedure: We analyzed 2504 admissions for children < 20 years old who underwent an allogeneic HSCT for a nonmalignant condition by using the Kids' Inpatient Database for the years 2000, 2003, 2006, 2009, and 2012. Changes in in‐hospital mortality and other outcomes were assessed over the study period using weighted analyses, which enabled generation of national estimates in each year. Results: The number of admissions for HSCT increased from 334 to 667 from 2000 to 2012, respectively; among them, the use of bone marrow decreased (66.5% to 34.1%, P < 0.001). In‐hospital mortality declined (13.4% to 7.1%, P = 0.04), as did bacteremia (28.7% to 10.1%, P < 0.001) and vascular catheter infections (18.8% to 8.7%, P = 0.006), but cytomegalovirus infections increased (4.9% to 15.9%, P < 0.001), as did adenovirus infections (1.8% to 6.9%, P < 0.001) from 2000 to 2012. Conclusion: Population‐based analyses demonstrated a substantial expansion of the utilization of HSCT occurred for pediatric nonmalignancies from 2000 to 2012 in the United States, whereas the in‐hospital mortality declined by approximately a half. Further research is needed to identify distinct contributing factors.