Prognosis of Allogeneic Haematopoietic Stem Cell Recipients Admitted to the Intensive Care Unit: A Retrospective, Single-Centre Study

Abstract

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.

Critical care of patients with cancer

“…More recently, their survival has improved, but mortality still remains high . The reported hospital mortality of patients in studies that were published after 2010 is in the range from 63% to 83% . Long‐term survival is uniformly poor, with reported 1‐year survival rates in recent publications ranging from 15% to 19% .…”

Survival of Allogeneic Hematopoietic Stem Cell Recipients Admitted to the Intensive Care Unit: Have We Reached the Limits?

“…We read the report by Lindgaard et al [1] and its editorial comment in the latest issue of Acta Haematologica with great interest [2]. In their single-center retrospective study, they tried to highlight short- and long-term prognostic factors of 54 adult allogeneic hematopoietic stem cell transplant (HSCT) patients admitted to their intensive care unit (ICU) between January 2007 and March 2012.…”

“…Lindgaard et al [1] should also explain the underlying causes of respiratory failure. In their patients, acute respiratory failure is often due to GvHD, sepsis and relapse.…”

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

“…Our original paper [1] detailed the experience from a single centre with 54 adult patients requiring admission to the intensive care unit (ICU). The Department of Haematology has a high level of treatment and is able to manage septic shock, for example, and to perform dialysis.…”