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Intensive Care Outcomes of Patients after High Dose Chemotherapy and Subsequent Autologous Stem Cell Transplantation: A Retrospective, Single Centre Analysis

High dose chemotherapy (HDT) followed by autologous peripheral blood stem cell transplantation (ASCT) is standard of care including a curative treatment option for several cancers. While much is known about the management of patients with allogenic SCT at the intensive care unit (ICU), data regardin...

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Autores principales: Karagiannis, Panagiotis, Sänger, Lena, Alsdorf, Winfried, Weisel, Katja, Fiedler, Walter, Kluge, Stefan, Wichmann, Dominic, Bokemeyer, Carsten, Fuhrmann, Valentin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7352739/
https://www.ncbi.nlm.nih.gov/pubmed/32599837
http://dx.doi.org/10.3390/cancers12061678
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author Karagiannis, Panagiotis
Sänger, Lena
Alsdorf, Winfried
Weisel, Katja
Fiedler, Walter
Kluge, Stefan
Wichmann, Dominic
Bokemeyer, Carsten
Fuhrmann, Valentin
author_facet Karagiannis, Panagiotis
Sänger, Lena
Alsdorf, Winfried
Weisel, Katja
Fiedler, Walter
Kluge, Stefan
Wichmann, Dominic
Bokemeyer, Carsten
Fuhrmann, Valentin
author_sort Karagiannis, Panagiotis
collection PubMed
description High dose chemotherapy (HDT) followed by autologous peripheral blood stem cell transplantation (ASCT) is standard of care including a curative treatment option for several cancers. While much is known about the management of patients with allogenic SCT at the intensive care unit (ICU), data regarding incidence, clinical impact, and outcome of critical illness following ASCT are less reported. This study included 256 patients with different cancer entities. Median age was 56 years (interquartile ranges (IQR): 45–64), and 67% were male. One-year survival was 89%; 15 patients (6%) required treatment at the ICU following HDT. The main reason for ICU admission was septic shock (80%) with the predominant focus being the respiratory tract (53%). Three patients died, twelve recovered, and six (40%) were alive at one-year, resulting in an immediate treatment-related mortality of 1.2%. Independent risk factors for ICU admission were age (odds ratio (OR) 1.05; 95% confidence interval (CI) 1.00–1.09; p = 0.043), duration of aplasia (OR: 1.37; CI: 1.07–1.75; p = 0.013), and Charlson comorbidity score (OR: 1.64; CI: 1.20–2.23; p = 0.002). HDT followed by ASCT performed at an experienced centre is generally associated with a low risk for treatment related mortality. ICU treatment is warranted mainly due to infectious complications and has a strong positive impact on intermediate-term survival.
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spelling pubmed-73527392020-07-15 Intensive Care Outcomes of Patients after High Dose Chemotherapy and Subsequent Autologous Stem Cell Transplantation: A Retrospective, Single Centre Analysis Karagiannis, Panagiotis Sänger, Lena Alsdorf, Winfried Weisel, Katja Fiedler, Walter Kluge, Stefan Wichmann, Dominic Bokemeyer, Carsten Fuhrmann, Valentin Cancers (Basel) Article High dose chemotherapy (HDT) followed by autologous peripheral blood stem cell transplantation (ASCT) is standard of care including a curative treatment option for several cancers. While much is known about the management of patients with allogenic SCT at the intensive care unit (ICU), data regarding incidence, clinical impact, and outcome of critical illness following ASCT are less reported. This study included 256 patients with different cancer entities. Median age was 56 years (interquartile ranges (IQR): 45–64), and 67% were male. One-year survival was 89%; 15 patients (6%) required treatment at the ICU following HDT. The main reason for ICU admission was septic shock (80%) with the predominant focus being the respiratory tract (53%). Three patients died, twelve recovered, and six (40%) were alive at one-year, resulting in an immediate treatment-related mortality of 1.2%. Independent risk factors for ICU admission were age (odds ratio (OR) 1.05; 95% confidence interval (CI) 1.00–1.09; p = 0.043), duration of aplasia (OR: 1.37; CI: 1.07–1.75; p = 0.013), and Charlson comorbidity score (OR: 1.64; CI: 1.20–2.23; p = 0.002). HDT followed by ASCT performed at an experienced centre is generally associated with a low risk for treatment related mortality. ICU treatment is warranted mainly due to infectious complications and has a strong positive impact on intermediate-term survival. MDPI 2020-06-24 /pmc/articles/PMC7352739/ /pubmed/32599837 http://dx.doi.org/10.3390/cancers12061678 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Karagiannis, Panagiotis
Sänger, Lena
Alsdorf, Winfried
Weisel, Katja
Fiedler, Walter
Kluge, Stefan
Wichmann, Dominic
Bokemeyer, Carsten
Fuhrmann, Valentin
Intensive Care Outcomes of Patients after High Dose Chemotherapy and Subsequent Autologous Stem Cell Transplantation: A Retrospective, Single Centre Analysis
title Intensive Care Outcomes of Patients after High Dose Chemotherapy and Subsequent Autologous Stem Cell Transplantation: A Retrospective, Single Centre Analysis
title_full Intensive Care Outcomes of Patients after High Dose Chemotherapy and Subsequent Autologous Stem Cell Transplantation: A Retrospective, Single Centre Analysis
title_fullStr Intensive Care Outcomes of Patients after High Dose Chemotherapy and Subsequent Autologous Stem Cell Transplantation: A Retrospective, Single Centre Analysis
title_full_unstemmed Intensive Care Outcomes of Patients after High Dose Chemotherapy and Subsequent Autologous Stem Cell Transplantation: A Retrospective, Single Centre Analysis
title_short Intensive Care Outcomes of Patients after High Dose Chemotherapy and Subsequent Autologous Stem Cell Transplantation: A Retrospective, Single Centre Analysis
title_sort intensive care outcomes of patients after high dose chemotherapy and subsequent autologous stem cell transplantation: a retrospective, single centre analysis
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7352739/
https://www.ncbi.nlm.nih.gov/pubmed/32599837
http://dx.doi.org/10.3390/cancers12061678
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