Risk factor for death in hematopoietic stem cell transplantation: are biomarkers useful to foresee the prognosis in this population of patients?

Massaro, Karin Schmidt Rodrigues; Macedo, Rodrigo Cauduro Oliveira; Castro, Begoña; Dulley, Frederico Luiz; Oliveira, Maura Salaroli de; Yasuda, Maria Aparecida Shikanai; Levin, Anna S.; Costa, Sílvia Figueiredo

doi:10.1007/s15010-014-0685-2

Cited by 21 publications

(15 citation statements)

References 28 publications

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“…Ней-тропеническая лихорадка (НЛ) -самое частое прояв-ление инфекционного процесса у больных после ВДХТ и аутоТГСК. Частота этого осложнения составляет 64,2-79,0 % [2][3][4]. Локализованная инфекция, сепсис и септический шок встречаются значительно реже [4].…”

Section: Introductionunclassified

“…Это прежде всего тип трансплантации: при аллогенной, особенно неродственной, риск летального исхода, в т. ч. связанного с инфекцией, значимо выше [4]. По-жилой возраст также относится к отягощающим фак-торам [4]. Что же касается только аутоТГСК, то наи-более перспективными предикторами ранних инфек-ционных осложнений в настоящее время считаются биохимические маркеры, такие как С-реактивный белок, прокальцитонин и пресепсин.…”

Section: Introductionunclassified

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Diagnostic and Prognostic Value of Biochemical Markers of Infectious Complications of High-Dose Therapy with Autologous Hematopoietic Stem Cell Transplantation in Malignant Lymphoproliferative Diseases

Саржевский¹,

Dubinina²,

Mel’nichenko³

2017

Клиническая онкогематология

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Aim. To evaluate diagnostic and prognostic value of C-reactive protein (CRP), procalcitonin (PCT) and presepsin (PSP) in patients with malignant lymphoproliferative disorders after a high-dose chemotherapy and auto-HSCT. Methods. 28 patients were included in the study (20 women and 8 men; 12 of them with Hodgkin’s lymphoma, 6 with non-Hodgkin’s lymphomas, and 10 with multiple myeloma). The median age was 40 years (23-66 years). The conditioning regimens were CBV, BEAM or melphalan 200 mg/m<sup>2</sup>. PSP, PCT and CRP levels were evaluated on the day of admission (DA), D+1, D+3, D+7 and on the day of discharge (DD). Depending on the presence of infectious complications, the patients were divided into 2 groups: group 1 - patients without complications (n = 12), group 2 - patients with complications (n = 16). In group 2 there were 15 patients with febrile neutropenia (FN) and 1 with sepsis. Results. The median (range) of FN development was 5.5 days. Median CRP level on the DA and the DD in group 1 was 2.25 mg/l (0.6-20.4) and 14.85 mg/l (3.7-50), respectively (p = 0.001), while in group 2 it was 3.2 mg/l (0.2-53) and 19.7 mg/l (5.1-152.2), respectively (p = 0.025). However, CRP did not significantly differ between groups 1 and 2 at any point of analysis. The study also demonstrated a significant increase in the PCT levels in both groups after allo-HSCT. Median PCT level on the DA and the DD in group 1 was 0.023 ng/ ml (0.02-0.112) and 0.07 ng/mL (0.02-0.356), respectively (p = 0.04), and in group 2 - 0.039 ng/ml (0.02-0.158) and 0.106 ng/mL (0.045-3.67), respectively (p = 0.001). Comparison of PCT levels on study days demonstrated no significant difference between groups. On the DA the median PSP level in group 1 was 166.5 pg/ml (77.2-476), on the DD it was 199 pg/ml (90-298) (p = 0.78). Median PSP levels in group 2 on the DA (129 pg/ml, range 84.2-501) and also on the DD (288.5 pg/ml, range 83.4-1345) were significantly different (p = 0.03). In the comparative analysis of PSP in groups 1 and 2, there were no significant differences on the DA and on the D+1. Significant difference in PSP levels between the analyzed groups was on the D+3, D+7 and on the DA. Conclusion. The preliminary data showed that PSP is the most sensitive marker of infectious complications in patients with lymphoproliferative diseases after auto-HSCT.

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Section: Introductionunclassified

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Diagnostic and Prognostic Value of Biochemical Markers of Infectious Complications of High-Dose Therapy with Autologous Hematopoietic Stem Cell Transplantation in Malignant Lymphoproliferative Diseases

Саржевский¹,

Dubinina²,

Mel’nichenko³

2017

Клиническая онкогематология

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“…[5][6][7] As a 116-amino-acid peptide typically produced in the thyroid, systemic production is substantially increased in the setting of microbial infection 8,9 and higher levels may be associated with more severe disease or sepsis. 10 Evaluation of procalcitonin in the setting of allogeneic HSCT is limited, [11][12][13] with no data regarding its role in the setting of ES. A clinical utility of using procalcitonin in oncology in general is demonstrated.…”

Section: Introductionmentioning

confidence: 99%

Procalcitonin and cytokine profiles in engraftment syndrome in pediatric stem cell transplantation

Shah

Watson

Yates

et al. 2016

Pediatric Blood & Cancer

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“…e Pseudomonas aeruginosa, em decorrência do aumento do uso profilático de fluorquinolonas. (38)(39)(40)(41) A bactéria gram positiva mais prevalente é o…”

Section: Epidemiologia E Impacto Da Neutropenia Febrilunclassified

Neutropenia febril em coorte de adultos submetidos ao transplante de células-tronco hematopoiéticas

Kuwano¹

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pela orientação, dedicação e por sempre ser uma fonte de inspiração na busca pelo aprimoramento pessoal e profissional. À minha família, pela compreensão e incentivo, e por sempre estarem ao meu lado durante todo o trabalho. Ao grupo de pesquisa "Manejo da terapia farmacológica na prática clínica do enfermeiro", pelas trocas de conhecimentos e discussões que auxiliaram na construção deste projeto. Ao estatístico Bernardo, pela paciência e auxílio na construção das análises. À Juliana Takahashi, pelo apoio nas questões bibliográficas. À Equipe de Enfermagem do Ambulatório de Quimioterapia do ICESP, pelas palavras de incentivo e amizade.. "Tornamos nosso mundo significativo pela coragem de nossas perguntas e pela profundidade de nossas respostas". Carl Sagan Kuwano MA. Neutropenia febril em coorte de adultos submetidos ao transplante de células tronco hematopoiéticas. [dissertação]. São Paulo (SP): Escola de Enfermagem, Universidade de São Paulo; 2018. RESUMO Introdução: A neutropenia febril (NF) é um evento adverso intrínseco ao transplante de células-tronco hematopoiéticas (TCTH), decorrente da mielossupressão ocasionada pelo procedimento, que impacta de modo importante na morbidade e na mortalidade do paciente. Objetivos: Analisar os pacientes submetidos ao TCTH quanto a ocorrência de NF. Método: Coorte retrospectiva conduzida com 61 pacientes submetidos ao TCTH no Hospital de Clínicas da Universidade Estadual de Campinas. Foram extraídos dados relativos a características basais dos pacientes, procedimento de TCTH, tempo de internação e desfecho clínico para determinar os fatores associados à NF. As variáveis independentes foram idade, sexo, comorbidades, diagnóstico, tipo de transplante, regime de condicionamento, fonte das células, nº de CD34, tempo de enxertia, escore de risco pré-TCTH do EBMT, SAPSII. A NF foi definida de acordo com o Common Terminology Criteria for Adverse Events (CTC/AE) v4.0, considerando o desfecho dicotômico, a duração em dias, a data da ocorrência, o grau e a análise de sobrevida. Os dados foram analisados por meio de testes paramétricos e não paramétricos, dependendo do nível de mensuração das variáveis e utilizaram-se Kaplan-Meier e regressão logística. Para todas as análises considerouse nível de significância de 5%. Resultados: A incidência de NF nos pacientes submetidos ao TCTH foi de 78,7%, com duração média de 8,3 dias, sem diferença significativa entre os tipos de transplantes (p=0,176). Não foram encontrados fatores de risco para a NF, porém, os pacientes submetidos ao transplante autólogo (p=0,022) e ao regime de condicionamento mieloablativo (p=0,026) apresentaram menor sobrevida para este evento adverso. Os pacientes que utilizaram ventilação mecânica (p=0,052), que necessitaram do uso de drogas vasoativas (p=0,012) e que foram a óbito (OR=9,66; p=0,052), apresentaram NF em sua totalidade. Conclusão: A incidência de NF foi expressiva e, ainda que não tenham sido identificados fatores associados a ela, os pacientes submetidos ao regime NMA e TCTH alogênico apresentaram maior...

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Risk factor for death in hematopoietic stem cell transplantation: are biomarkers useful to foresee the prognosis in this population of patients?

Cited by 21 publications

References 28 publications

Diagnostic and Prognostic Value of Biochemical Markers of Infectious Complications of High-Dose Therapy with Autologous Hematopoietic Stem Cell Transplantation in Malignant Lymphoproliferative Diseases

Diagnostic and Prognostic Value of Biochemical Markers of Infectious Complications of High-Dose Therapy with Autologous Hematopoietic Stem Cell Transplantation in Malignant Lymphoproliferative Diseases

Procalcitonin and cytokine profiles in engraftment syndrome in pediatric stem cell transplantation

Neutropenia febril em coorte de adultos submetidos ao transplante de células-tronco hematopoiéticas

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