International Journal of Hematology

DOI: 10.1007/s12185-018-2536-x Pages: 622-629

Long-term outcomes in patients treated in the intensive care unit after hematopoietic stem cell transplantation

1. Okayama University Hospital, Department of Hematology and Oncology

2. Okayama University Hospital, Department of Transfusion Medicine

3. Okayama University Hospital, Department of Anesthesiology and Resuscitology

Correspondence to:
Nobuharu Fujii
Tel: +81-86-235-7227
Email: nfujii@md.okayama-u.ac.jp

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Abstract

The number of patients who are successfully discharged from the intensive care unit (ICU) after hematopoietic stem cell transplantation (HSCT) remains limited. Most previous studies have evaluated short-term outcomes using ICU mortality; there have been comparatively fewer reports of long-term outcomes. We retrospectively analyzed 39 HSCT patients admitted to the ICU for the first time between April 2008 and July 2014. Performance status was evaluated in four long-term survivors in July 2016. Median age at ICU admission was 54 years (range 30–68). In total, 33 patients (70.2%) required mechanical ventilation and 31 patients (66%) required dialysis. The median OS from first ICU admission was 41 days (95% confidence interval [CI]: 22–64) and the 1-year survival rate was 12.8% (95% CI 4.7–25.2). No statistically significant factors were associated with short-term outcomes. Among long-term outcomes, a second or subsequent HSCT and neutropenia at ICU admission were significant risk factors. Four of 10 ICU survivors have survived with good performance status for a median of 1994 (1203–2633) days. Our results suggest that the number of prior transplants and neutropenia at ICU admission may influence OS.

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