Gallstones in pediatric hematopoietic cell transplant survivors with up to 40 years of follow-up
| Autor: | Paul A. Hoffmeister, Barry E. Storer, George B. McDonald, K. Scott Baker |
|---|---|
| Rok vydání: | 2014 |
| Předmět: |
Male
medicine.medical_specialty Pediatrics Adolescent medicine.medical_treatment Hematopoietic stem cell transplantation Gallstones Article Risk Factors hemic and lymphatic diseases medicine Prevalence Humans Cholecystectomy Survivors Child Proportional Hazards Models Retrospective Studies Proportional hazards model business.industry Incidence (epidemiology) Incidence Hematopoietic Stem Cell Transplantation Infant Retrospective cohort study Hematology medicine.disease Surgery Transplantation surgical procedures operative Graft-versus-host disease Oncology Child Preschool Pediatrics Perinatology and Child Health Multivariate Analysis Female business Follow-Up Studies |
| Zdroj: | Journal of pediatric hematology/oncology. 36(6) |
| ISSN: | 1536-3678 |
| Popis: | To determine risk factors for the development of gallstones and the prevalence of related cholecystectomy in children following hematopoietic cell transplantation (HCT).A retrospective chart review of 1343 patients aged below 18 years old who survived at least 1 year after HCT from 1969 to 2011 was performed. Multivariate Cox regression models were used to estimate the hazard ratio (HR) of risk factors associated with gallstones.Gallstones developed in 91 patients, a median of 3.5 (range, 0.1 to 30.9) years after HCT at 16.3 (range, 0.8 to 44.2) years of age, with a 40-year cumulative incidence of 11%. At initial diagnosis, 61 (67%) patients were symptomatic and 30 (23%) had incidental gallstones. Risk factors associated with gallstones included autologous transplant (HR=2.7, P=0.02), unrelated donor (HR=2.0, P=0.05), grade 3 to 4 acute graft-versus-host disease (GVHD) (HR=2.2, P=0.03), chronic GVHD (HR=2.0, P=0.05), second transplant (HR=2.3, P=0.03), diabetes (HR=2.2, P=0.05), and estrogen therapy (HR=1.8, P=0.03). Fifty-six patients underwent cholecystectomy. The prevalence of cholecystectomy among 853 surviving patients was 5.2%.Childhood HCT patients have an increased risk of developing gallstones. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|