Mortality hazard functions as related to neutropenia at different times after marrow transplantation
| Autor: | Fritz Offner, Paul J. Martin, Beverly Torok-Storb, Gary Schoch, LD Fisher |
|---|---|
| Rok vydání: | 1996 |
| Předmět: |
Adult
Male Risk medicine.medical_specialty Neutropenia Transplantation Conditioning Adolescent Neutrophils Immunology Biochemistry Leukocyte Count hemic and lymphatic diseases Internal medicine Diseases in Twins medicine Humans Child Survival analysis Aged Bone Marrow Transplantation Proportional Hazards Models Leukopenia business.industry Proportional hazards model Graft Survival Infant Cell Biology Hematology Middle Aged medicine.disease Survival Analysis Hematopoiesis Surgery Child Preschool Relative risk Absolute neutrophil count Female medicine.symptom Complication business |
| Zdroj: | Blood. 88:4058-4062 |
| ISSN: | 1528-0020 0006-4971 |
| DOI: | 10.1182/blood.v88.10.4058.bloodjournal88104058 |
| Popis: | We characterized the relationship between severe neutropenia and risk of death in 2,276 patients after marrow transplantation to define objective and clinically relevant criteria that could be used to judge the timing and potential value of interventions designed to improve survival in patients with delayed initial engraftment. Proportional hazard models were used to estimate the relative risk of death before day 100 among patients alive on any given day with an absolute neutrophil count (ANC) less than 100/microL compared with those alive on the same day with an ANC > or = 100/microL. Between day 10 and 14, the risk ratio remained close to 1.0, indicating that the risk of death before day 100 for patients with an ANC less than 100/microL was similar to that for patients with an ANC > or = 100/microL. Between day 15, when 38% of patients had an ANC less than 100/microL, and day 26, when 3.8% of patients had an ANC less than 100/microL, the risk ratio showed an overall upward trend, indicating that patients with an ANC less than 100/microL had a higher risk of death before day 100 than those with an ANC > or = 100/microL. Thereafter, the risk ratio fluctuated between 2.01 and 5.78, indicating consistently higher risks of mortality in patients with severe neutropenia. However, allogeneic and autologous transplant recipients each had distinctive risk ratio patterns. These results could be helpful in deciding the appropriate timing for treatment given to improve graft function after marrow transplantation. |
| Databáze: | OpenAIRE |
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