Patient and Provider Preferences for Survivorship Care Plans for Allogeneic Hematopoietic Cell Transplantation (HCT) Survivors: A Qualitative Study

Autor: Elizabeth Murphy, Balkrishna N. Jahagirdar, Ellen M. Denzen, Wael Saber, Barry A. Schatz, Karen L. Syrjala, J. Douglas Rizzo, Beatrice Abetti, John R. Wingard, Lizette Salazar, Navneet S. Majhail, Naynesh Kamani, K. Scott Baker
Rok vydání: 2015
Předmět:
Zdroj: Biology of Blood and Marrow Transplantation. 21:S174-S175
ISSN: 1083-8791
DOI: 10.1016/j.bbmt.2014.11.256
Popis: s / Biol Blood Marrow Transplant 21 (2015) S171eS184 S174 malignancy in 34 patients (64%), lymphoid malignancy in 16 (30%) and plasma cell dyscrasia in 3 (6%). Sixteen (30%) had myeloablative conditioning. Median time from onset of symptoms to diagnosis was 2 days (0-15) and median time from transplant to diagnosis was 11 months (0-48). Twentyeight patients (53%) had URTI symptoms at presentation, 11 (21%) had LRTI and 14 (26%) had progression from URTI to LRTI. Stratifying per the ISI criteria, 16 patients (30%) were low risk, 31 (59%) were moderate and 6 (11%) were high risk. Median survival post RSV diagnosis was 17 months (0-78). Forty-six patients received oral ribavirin, 4 received aerosolized ribavirin and 3 were not treated. Five patients (3 high and 2 moderate risk) had RSV associated mortality with a median time to death of 8 days (7-18) due to respiratory failure and/or acute respiratory distress syndrome. Case fatality among high, moderate and low risk patients were 50%, 6% and 0%, respectively. Overall survival was statistically significant among the risk groups (P 0.0112). Predicting LRTI at diagnosis and risk of URTI to LRTI progression was however not significant (P 0.1375 and 0.4505, respectively). Conclusion: Use of oral ribavirin in low and moderate risk patients was associated with an excellent outcome. The ISI predicted survival but not risk of LRTI post RSV infection in an independent cohort of allogeneic stem cell transplant recipients treated with oral ribavirin. Elevated case fatality in high risk cases highlights the need for better therapies in this group of patients.
Databáze: OpenAIRE
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