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

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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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Acknowledgements

The authors would like to express their appreciation for the contributions of all the doctors and nurses at Okayama University Hospital. The authors would like to thank Enago (http://www.enago.jp) for the English language review.

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Authors and Affiliations

  1. Department of Hematology and Oncology, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan

    Makoto Nakamura, Nobuharu Fujii, Shuntaro Ikegawa, Keisuke Seike, Tomoko Inomata, Yasuhisa Sando, Keiko Fujii, Hisakazu Nishimori, Ken-ichi Matsuoka & Yoshinobu Maeda

  2. Department of Transfusion Medicine, Okayama University Hospital, Okayama, Japan

    Makoto Nakamura, Nobuharu Fujii, Keisuke Seike, Yasuhisa Sando & Keiko Fujii

  3. Department of Anesthesiology and Resuscitology, Okayama University Hospital, Okayama, Japan

    Kazuyoshi Shimizu & Hiroshi Morimatsu

Authors
  1. Makoto Nakamura
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  2. Nobuharu Fujii
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  3. Kazuyoshi Shimizu
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  4. Shuntaro Ikegawa
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  5. Keisuke Seike
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  6. Tomoko Inomata
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  7. Yasuhisa Sando
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  8. Keiko Fujii
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  9. Hisakazu Nishimori
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  10. Ken-ichi Matsuoka
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  11. Hiroshi Morimatsu
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  12. Yoshinobu Maeda
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Correspondence to Nobuharu Fujii.

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Nakamura, M., Fujii, N., Shimizu, K. et al. Long-term outcomes in patients treated in the intensive care unit after hematopoietic stem cell transplantation. Int J Hematol 108, 622–629 (2018). https://doi.org/10.1007/s12185-018-2536-x

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  • DOI: https://doi.org/10.1007/s12185-018-2536-x

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