Cardiac and Vascular Events in Patients with History of Hematopoietic STEM CELL Transplant (HSCT) Are NOT Associated with Poor Outcomes: Analysis of National Inpatient Sample 2010-2014

Introduction Clostridium difficile infection (CDI) is the leading cause of infectious diarrhea among hospitalized patients. Patients undergoing hematopoietic stem-cell transplant (HSCT), either autologous stem cell transplant (Auto-SCT) or allogeneic stem cell transplant (Allo-SCT), are at high risk for CDI. We aim to describe the incidence and epidemiological trends for CDI in Auto-SCT and Allo-SCT in the United States, using the National Inpatient Sample (NIS) database provided by Healthcare Cost and Utilization Project (HCUP). Methods A descriptive, retrospective study was conducted on the National Inpatient Sample (NIS) Database for the years 2005-2014. Admissions with diagnosis of CDI were selected based on International Classification of Diseases-Ninth Revision (ICD-9), Clinical Modification diagnoses codes (00845). ICD-9 procedure codes were used to identify HSCT hospitalizations (autologous: 4101, 4104, 4107, and 4109; allogeneic: 4102, 4103, 4105, 4106, and 4108). Complex survey design, weights and clustering were accounted for during analysis. Results The mean age of patients undergoing HSCT was 45.69 + 20.35 years and 41.13% were female. There were total of 89,374 Auto-SCT patients and 66,044 Allo-SCT patients hospitalized between 2005-2014. Auto-SCTs constituted 55.5% of all the HSCTs. The incidence of Auto-SCT related hospitalizations increased from 205 per million admissions (pma) in 2005 to 291 pma in 2014 with an annual percentage change (APC) of 5.8, p<0.001. During the same period the incidence of Allo-SCT related hospitalizations increased from 151 pma to 224 pma with and APC of 6.3, p<0.001. Overall 6.67% of patients with Auto-SCT and 9.96% of Allo-SCT were diagnosed with CDI. There were statistically higher CDI rates in Allo-SCT when compared to Auto-SCT (p<0.001). The incidence of CDI in Auto-SCT patients showed a non-significant decrease from 2005-2009 and a significant increase from 2009-2014 (APC 7, p<0.001). The incidence of CDI in Allo-SCT patients increased significantly from 2005 to 2014 with an APC of 5.9, p<0.001. Conclusion The number of individuals being hospitalized for HSCTs in the United States is increasing and this increase is seen for both Auto-SCT and Allo-SCT procedures. One in fifteen patients undergoing Auto-SCT and one in ten patients undergoing Allo-SCT were diagnosed with CDI during hospitalization. There were significantly more CDIs in patients with Allo-SCT when compared to Auto-SCTs. The incidence of CDI in patients undergoing both Autologous and Allogeneic HSCT increased from 2005-2014 in the United States. Disclosures No relevant conflicts of interest to declare.

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History of Infection Prior to Hematopoietic Stem Cell Transplant in the Recipient as a Risk Factor to Develop Acute Graft versus Host Disease

Journal of Cancer Therapy ◽

10.4236/jct.2019.104026 ◽

2019 ◽

Vol 10 (04) ◽

pp. 327-335

Author(s):

Alberto Olaya-Vargas ◽

Iván Castorena-Villa ◽

Martin Pérez-García ◽

Gerardo Lopéz-Hernández ◽

Nideshda Ramírez-Uribe ◽

...

Keyword(s):

Risk Factor ◽

Stem Cell ◽

Graft Versus Host Disease ◽

Hematopoietic Stem Cell Transplant ◽

Stem Cell Transplant ◽

Cell Transplant ◽

Hematopoietic Stem ◽

Graft Versus Host ◽

History Of ◽

Acute Graft

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The Ende brothers and the arcane history of the first umbilical cord blood hematopoietic stem cell transplant

Transfusion ◽

10.1111/j.1537-2995.2009.02310.x ◽

2009 ◽

Vol 49 (9) ◽

pp. 2010-2010 ◽

Cited By ~ 2

Author(s):

Lewis Glasser

Keyword(s):

Stem Cell ◽

Cord Blood ◽

Hematopoietic Stem Cell ◽

Umbilical Cord ◽

Umbilical Cord Blood ◽

Hematopoietic Stem Cell Transplant ◽

Stem Cell Transplant ◽

Cell Transplant ◽

Hematopoietic Stem ◽

History Of

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Acute Myeloid Leukaemia with Vitreous Haemorrhage: Management Challenge in a Third World Country

American Journal of Clinical Pathology ◽

10.1093/ajcp/aqaa161.238 ◽

2020 ◽

Vol 154 (Supplement_1) ◽

pp. S109-S109

Author(s):

A T Olatinwo ◽

A A Ogbenna ◽

A Bolarinwa

Keyword(s):

Bone Marrow ◽

Stem Cell ◽

Hematopoietic Stem Cell ◽

Hematopoietic Stem Cell Transplant ◽

Stem Cell Transplant ◽

Vitreous Haemorrhage ◽

Cell Transplant ◽

Hematopoietic Stem ◽

History Of ◽

Acute Myeloid

Abstract Casestudy Leukaemic ophthalmopathy is commoner in acute myeloid leukaemias. Ophthalmic involvement in leukaemias is classified into: Primary or Secondary. Methods A 35-year-old man with history of working in an oil and gas company for 3years who presented 9months ago on account of one month history of recurrent fever, occasional bone pain and generalised body weakness.Had associated history of passage of dark coloured urine, mouth ulcers, mouth bleeds and dizziness. CBC at presentation showed WBC of 102,300/mcl with 79% blasts, hemoglobin of 5.4g/dL, platelet count of 12,000/mcl. Symptoms were consistent with leukostasis, and he had leukoreduction with exchange blood transfusion and hydroxyurea. Bone marrow aspirate confirmed the diagnosis of AML FAB M2. Bone marrow biopsy showed hypercellular marrow with increased myeloid series, other series depressed. Three days after admission, he complained of painless blurred vision bilaterally and feeling of objects appearing reddish, a review by ophthalmologist with an assessment of bilateral retinal haemorrhage secondary to AML. B – Scan done showed whitish elevated hyperechoic mass (parapapillary) with moderate dot echoes in the vitreous bilaterally. They planned for dilated fundoscopy and advised haematologist to commence chemotherapy as planned. He then had standard induction with cytarabine and daunorubicin.Post chemotherapy showed pancytopenia secondary to chemotherapy. Further review by Ophthalmologist showed bilateral vitreous haemorrhage secondary to bilateral choroidal mass and then planned for vitrectomy and also had bilateral intravitreal bevacizumab Day 14 bone marrow exam showed hypocellularity with absence of blasts indicating remission. He subsequently underwent cycle 1 of consolidation with high-dose cytarabine with the goal to proceed with allogeneic hematopoietic stem cell transplant (HSCT). Post consolidation, patient has had surgeries of both eyes and subsequently regained full vision in both eyes. Though patient is yet to re-present for post consolidation chemotherapy despite adequate counsel due to financial constraints and yet to have allogeneic hematopoietic stem cell transplant (HSCT) and last showed up for follow up four months ago. Results Patient regained full vision in both eyes Conclusion This case illustrates that vitreous haemorrhage in Patients with AML can be effectively managed in a resource limited setting.

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