Survival Impact of Early Post-Transplant Toxicities in Pediatric and Adolescent Patients Undergoing Allogeneic Hematopoietic Cell Transplantation for Malignant and Nonmalignant Diseases: Recognizing Risks and Optimizing Outcomes
| Autor: | Prakash Satwani, Justine M. Kahn, Andrew L. Kung, Monica Bhatia, Diane George, Grace Yoon-Jeong Kim, Zhezhen Jin, James Garvin, Mahvish Qureshi, Esra Karamehmet, Naima Al Mulla, Anya Levinson |
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| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
Oncology
Adult Male medicine.medical_specialty Transplantation Conditioning Adolescent Population Risk Assessment Article 03 medical and health sciences Young Adult 0302 clinical medicine Risk Factors Internal medicine medicine Humans Transplantation Homologous education Child Busulfan Retrospective Studies Transplantation education.field_of_study Hematopoietic cell business.industry Incidence (epidemiology) Hematopoietic Stem Cell Transplantation Infant Retrospective cohort study Hematology Myeloablative Agonists Survival Analysis Post transplant 3. Good health Surgery Treatment Outcome 030220 oncology & carcinogenesis Child Preschool Female Stem cell business 030215 immunology medicine.drug |
| Popis: | In pediatric and adolescent patients undergoing allogeneic hematopoietic cell transplantation, treatment-related toxicities remain a clinical challenge. A paucity of data investigates the risks for and survival impact of treatment-related toxicities in this population. Here the authors assess the relative toxicity of myeloablative, reduced-toxicity, and reduced-intensity conditioning regimens; identify patient-related predictors of post-transplant toxicities; and investigate the impact of early post-transplant toxicities on transplant-related mortality (TRM). In this retrospective study, 164 patients (aged 1 to 22 years) underwent allogeneic stem cell transplantation after busulfan-based conditioning for malignant and nonmalignant diseases between 2000 and 2014. The number of grades III to IV toxicities between days 0 and +30 was calculated for each patient. TRM was calculated to 2 years. Median patient age was 9 years, and median number of toxicities was 3 (range, 0 to 17). The 100-person day incidence of post-transplant toxicities in myeloablative conditioning was not different from the incidence in reduced-toxicity conditioning (13.88 versus 13.59, P = .812). Reduced intensity was less toxic than both myeloablative and reduced toxicity (13.75 versus 8.41, P |
| Databáze: | OpenAIRE |
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