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International Journal of Hematology

, Volume 108, Issue 6, pp 622–629 | Cite as

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

  • Makoto Nakamura
  • Nobuharu Fujii
  • Kazuyoshi Shimizu
  • Shuntaro Ikegawa
  • Keisuke Seike
  • Tomoko Inomata
  • Yasuhisa Sando
  • Keiko Fujii
  • Hisakazu Nishimori
  • Ken-ichi Matsuoka
  • Hiroshi Morimatsu
  • Yoshinobu Maeda
Original Article
  • 59 Downloads

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.

Keywords

Intensive care unit Hematopoietic stem cell transplantation Neutropenia Number of prior transplants Long-term outcomes 

Notes

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.

Compliance with ethical standards

Conflict of interest

The authors report no potential competing conflicts of interest.

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Copyright information

© The Japanese Society of Hematology 2018

Authors and Affiliations

  • Makoto Nakamura
    • 1
    • 2
  • Nobuharu Fujii
    • 1
    • 2
  • Kazuyoshi Shimizu
    • 3
  • Shuntaro Ikegawa
    • 1
  • Keisuke Seike
    • 1
    • 2
  • Tomoko Inomata
    • 1
  • Yasuhisa Sando
    • 1
    • 2
  • Keiko Fujii
    • 1
    • 2
  • Hisakazu Nishimori
    • 1
  • Ken-ichi Matsuoka
    • 1
  • Hiroshi Morimatsu
    • 3
  • Yoshinobu Maeda
    • 1
  1. 1.Department of Hematology and OncologyOkayama University HospitalOkayamaJapan
  2. 2.Department of Transfusion MedicineOkayama University HospitalOkayamaJapan
  3. 3.Department of Anesthesiology and ResuscitologyOkayama University HospitalOkayamaJapan

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