Allogeneic Haematopoietic Stem Cell Recipients Admitted to the Intensive Care Unit: Survival and Prognosis

2016 ◽  
Vol 135 (4) ◽  
pp. 226-227
Author(s):  
Sidsel Christy Lindgaard
2015 ◽  
Vol 135 (2) ◽  
pp. 72-78 ◽  
Author(s):  
Sidsel Christy Lindgaard ◽  
Jonas Nielsen ◽  
Anders Lindmark ◽  
Henrik Sengeløv

Background: Allogeneic haematopoietic stem cell transplantation (HSCT) is a procedure with inherent complications and intensive care may be necessary. We evaluated the short- and long-term outcomes of the HSCT recipients requiring admission to the intensive care unit (ICU). Methods: We retrospectively examined the outcome of 54 adult haematological HSCT recipients admitted to the ICU at the University Hospital Rigshospitalet between January 2007 and March 2012. Results: The overall in-ICU, in-hospital, 6-month and 1-year mortality rates were 46.3, 75.9, 79.6 and 86.5%, respectively. Mechanical ventilation had a statistically significant effect on in-ICU (p = 0.02), 6-month (p = 0.049) and 1-year (p = 0.014) mortality. Renal replacement therapy also had a statistically significant effect on in-hospital (p = 0.038) and 6-month (p = 0.026) mortality. Short ICU admissions, i.e. <10 days, had a statistically significant positive effect on in-hospital, 6-month and 1-year mortality (all p < 0.001). The SAPS II, APACHE II and SOFA scoring systems grossly underestimated the actual in-hospital mortality observed for these patients. Conclusion: The poor prognosis of critically ill HSCT recipients admitted to the ICU was confirmed in our study. Mechanical ventilation, renal replacement therapy and an ICU admission of ≥10 days were each risk factors for mortality in the first year after ICU admission.


Author(s):  
William M. Townsend ◽  
Emma C. Morris

Patients with haematological malignancies require admission to the intensive care unit (ICU) due to the underlying disease, as a consequence of treatment with chemotherapy or after haematopoietic stem cell transplantation. With an increasing numbers of patients being diagnosed with these diseases and longer survival as treatments improve, the burden on ICU is anticipated to increase. There is compelling evidence that patients should not be denied admission to ICU based on the presence of a haematological malignancy. In this chapter the disease- and treatment-related reasons for ICU admission, outcome, and risk prediction scores for patients with haematological malignancies are discussed.


2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Christian S. Michel ◽  
Daniel Teschner ◽  
Irene Schmidtmann ◽  
Matthias Theobald ◽  
Beate Hauptrock ◽  
...  

AbstractPatients undergoing allogeneic hematopoietic stem cell transplantation have a high morbidity and mortality, especially after admission to intensive care unit (ICU) during peri-transplant period. The objective of this study was to identify new clinical and biological parameters and validate prognostic scores associated with ICU, short-and long-term survival. Significant differences between ICU survivors and ICU non-survivors for the clinical parameters invasive mechanical ventilation, urine output, heart rate, mean arterial pressure, and amount of vasopressors have been measured. Among prognostic scores (SOFA, SAPSII, PICAT, APACHE II, APACHE IV) assessing severity of disease and predicting outcome of critically ill patients on ICU, the APACHE II score has shown most significant difference (p = 0.002) and the highest discriminative power (area under the ROC curve (AUC) 0.74). An elevated level of lactate at day of admission was associated with poor survival on ICU and the most significant independent parameter (p < 0.001). In our cohort kidney damage with low urine output has a highly relevant impact on ICU, short- and long-term overall survival. The APACHE II score was superior predicting ICU mortality compared to all other tested prognostic scores for patients on ICU during peri-transplant period.


Cancers ◽  
2020 ◽  
Vol 12 (11) ◽  
pp. 3398
Author(s):  
Jérémie Rouger-Gaudichon ◽  
Eric Thébault ◽  
Arthur Félix ◽  
Aurélie Phulpin ◽  
Catherine Paillard ◽  
...  

Data regarding coronavirus disease 2019 (COVID-19) description are still limited in pediatric oncology. The French society of pediatric oncology (SFCE) initiated a study to better describe COVID-19 in patients followed in French pediatric oncology and hematology wards. All patients diagnosed with COVID-19 and followed in a SFCE center were enrolled. Data from medical records were analyzed for all patients enrolled up to the end of May 2020. Data were available for 37 patients. Thirty-one were children under 18 years of age. Nineteen patients were female. Seventeen patients had a solid tumor, 16 had a hematological malignancy and four recently underwent hematopoietic stem cell transplantation (HSCT) for non-oncological conditions. Twenty-eight patients presented symptoms, most often with fever, cough, rhinorrhea and asthenia. Ground-glass opacities were the most frequent radiological finding with abnormalities mostly bilateral and peripherally distributed. Twenty-four patients received chemotherapy a month prior to COVID-19 diagnosis. Most patients did not require hospitalization. Three patients required oxygen at the time of diagnosis. In total, five patients were admitted in an intensive care unit because of COVID-19 and one died from the disease. Children and young adults treated for a cancer and/or with a HSCT may be at risk for severe COVID-19 and should be closely monitored.


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