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Modeling Long-Term Erythropoietic Recovery After Allogeneic Stem Cell Transplants in Pediatric Patients
Long term erythropoietic reconstitution after allogeneic hematopoietic stem cell transplantation (alloHSCT) has not been extensively studied. We aimed to describe erythropoietic reconstitution as an indicator of long-term graft function by modeling hemoglobin levels during the first 3 years post HSC...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7734089/ https://www.ncbi.nlm.nih.gov/pubmed/33330281 http://dx.doi.org/10.3389/fped.2020.584156 |
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author | von Asmuth, Erik G. J. Mohseny, Alexander B. Putter, Hein Schilham, Marco W. Lankester, Arjan C. |
author_facet | von Asmuth, Erik G. J. Mohseny, Alexander B. Putter, Hein Schilham, Marco W. Lankester, Arjan C. |
author_sort | von Asmuth, Erik G. J. |
collection | PubMed |
description | Long term erythropoietic reconstitution after allogeneic hematopoietic stem cell transplantation (alloHSCT) has not been extensively studied. We aimed to describe erythropoietic reconstitution as an indicator of long-term graft function by modeling hemoglobin levels during the first 3 years post HSCT in pediatric patients. We retrospectively included 414 patients and 11,957 measurements. The largest hemoglobin increase was at day 45 and levels reached a steady state at day 648 with a level of 7.48 mmol/L. In patients transplanted for hematological malignancies hemoglobin levels normalized faster (p < 0.0001). Increasing patient age correlated with faster recovery (p < 0.0001), while donor age had no influence. Conditioning, donor type and graft source did not influence recovery significantly. In the ABO mismatched group there was a transient negative effect on hemoglobin levels, and a delay in reticulocyte recovery (21 vs. 19 days; p = 0.012). In contrast, hemoglobin levels reached a higher plateau beyond 9 months in these patients (p < 0.0001). After alloHSCT, experiencing a CMV reactivation negatively affected reconstitution (p = 0.034), while EBV reactivations and acute graft vs. host disease did not. In summary, erythropoietic recovery was mainly influenced by patient factors and primary disease, and less influenced by donor factors. |
format | Online Article Text |
id | pubmed-7734089 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-77340892020-12-15 Modeling Long-Term Erythropoietic Recovery After Allogeneic Stem Cell Transplants in Pediatric Patients von Asmuth, Erik G. J. Mohseny, Alexander B. Putter, Hein Schilham, Marco W. Lankester, Arjan C. Front Pediatr Pediatrics Long term erythropoietic reconstitution after allogeneic hematopoietic stem cell transplantation (alloHSCT) has not been extensively studied. We aimed to describe erythropoietic reconstitution as an indicator of long-term graft function by modeling hemoglobin levels during the first 3 years post HSCT in pediatric patients. We retrospectively included 414 patients and 11,957 measurements. The largest hemoglobin increase was at day 45 and levels reached a steady state at day 648 with a level of 7.48 mmol/L. In patients transplanted for hematological malignancies hemoglobin levels normalized faster (p < 0.0001). Increasing patient age correlated with faster recovery (p < 0.0001), while donor age had no influence. Conditioning, donor type and graft source did not influence recovery significantly. In the ABO mismatched group there was a transient negative effect on hemoglobin levels, and a delay in reticulocyte recovery (21 vs. 19 days; p = 0.012). In contrast, hemoglobin levels reached a higher plateau beyond 9 months in these patients (p < 0.0001). After alloHSCT, experiencing a CMV reactivation negatively affected reconstitution (p = 0.034), while EBV reactivations and acute graft vs. host disease did not. In summary, erythropoietic recovery was mainly influenced by patient factors and primary disease, and less influenced by donor factors. Frontiers Media S.A. 2020-11-30 /pmc/articles/PMC7734089/ /pubmed/33330281 http://dx.doi.org/10.3389/fped.2020.584156 Text en Copyright © 2020 von Asmuth, Mohseny, Putter, Schilham and Lankester. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Pediatrics von Asmuth, Erik G. J. Mohseny, Alexander B. Putter, Hein Schilham, Marco W. Lankester, Arjan C. Modeling Long-Term Erythropoietic Recovery After Allogeneic Stem Cell Transplants in Pediatric Patients |
title | Modeling Long-Term Erythropoietic Recovery After Allogeneic Stem Cell Transplants in Pediatric Patients |
title_full | Modeling Long-Term Erythropoietic Recovery After Allogeneic Stem Cell Transplants in Pediatric Patients |
title_fullStr | Modeling Long-Term Erythropoietic Recovery After Allogeneic Stem Cell Transplants in Pediatric Patients |
title_full_unstemmed | Modeling Long-Term Erythropoietic Recovery After Allogeneic Stem Cell Transplants in Pediatric Patients |
title_short | Modeling Long-Term Erythropoietic Recovery After Allogeneic Stem Cell Transplants in Pediatric Patients |
title_sort | modeling long-term erythropoietic recovery after allogeneic stem cell transplants in pediatric patients |
topic | Pediatrics |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7734089/ https://www.ncbi.nlm.nih.gov/pubmed/33330281 http://dx.doi.org/10.3389/fped.2020.584156 |
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