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

TY - JOUR

T1 - Intensive Care Outcomes of Patients after High Dose Chemotherapy and Subsequent Autologous Stem Cell Transplantation: A Retrospective, Single Centre Analysis

AU - Karagiannis, Panagiotis

AU - Sänger, Lena

AU - Alsdorf, Winfried

AU - Weisel, Katja

AU - Fiedler, Walter

AU - Kluge, Stefan

AU - Wichmann, Dominic

AU - Bokemeyer, Carsten

AU - Fuhrmann, Valentin

PY - 2020/6/24

Y1 - 2020/6/24

N2 - 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.

AB - 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.

U2 - 10.3390/cancers12061678

DO - 10.3390/cancers12061678

M3 - SCORING: Journal article

C2 - 32599837

VL - 12

JO - CANCERS

JF - CANCERS

SN - 2072-6694

IS - 6

M1 - 1678

ER -