Hematology (Amsterdam, Netherlands) · 2025
Sepsis and organ failure are the major risks for allogeneic transplant patients in the post- or late- engraftment phase admitted to the ICU.
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Serries Michael, Faßbender Lisa, Zenzen Hannah, Heine Mario, Holderried Tobias A W, Brossart Peter, Schwab Katjana
Аннотация
OBJECTIVES: Allogeneic hematopoietic stem cell transplantation (allo-HSCT) can lead to complications, depending on the period of the transplantation. Our study aimed to evaluate the outcome and prognostic parameters for the survival of patients admitted to the intensive care unit (ICU) in the post- or late-engraftment phase.
METHODS: The survival of patients aged ≥ 18 years in the post- or predominantly late-engraftment phase was analyzed retrospectively by using baseline data, laboratory parameters, scoring systems and vital parameters.
RESULTS: 46 cases were recorded. Sepsis-related respiratory failure was the leading ICU admission cause. Invasive mechanical ventilation (p = 0.048) and renal replacement therapy (p < 0.001) showed a significant impact on survival. Furthermore, a Sequential Organ Failure Assessment Score (SOFA-score) > 7 (p = 0.033), an Acute Physiology And Chronic Health Evaluation Score II (APACHE-II-score) > 14 (p = 0.017) and a Simplified Acute Physiology Score II (SAPS-II-score) > 35 (p = 0.001) showed a significantly lower survival.
DISCUSSION: Sepsis and organ failure remain substantial factors in ICU mortality, as reflected by clinical scores, laboratory parameters and intensive care interventions. Furthermore, our data indicates that demographic factors like age do not affect the outcome of allo-HSCT.
CONCLUSION: Our study shows that this specific engraftment cohort does not demonstrate different survival rates compared to patients in the early and post-engraftment phases. However, organ failure and sepsis remain significant contributors to the high mortality rates observed in the ICU.
METHODS: The survival of patients aged ≥ 18 years in the post- or predominantly late-engraftment phase was analyzed retrospectively by using baseline data, laboratory parameters, scoring systems and vital parameters.
RESULTS: 46 cases were recorded. Sepsis-related respiratory failure was the leading ICU admission cause. Invasive mechanical ventilation (p = 0.048) and renal replacement therapy (p < 0.001) showed a significant impact on survival. Furthermore, a Sequential Organ Failure Assessment Score (SOFA-score) > 7 (p = 0.033), an Acute Physiology And Chronic Health Evaluation Score II (APACHE-II-score) > 14 (p = 0.017) and a Simplified Acute Physiology Score II (SAPS-II-score) > 35 (p = 0.001) showed a significantly lower survival.
DISCUSSION: Sepsis and organ failure remain substantial factors in ICU mortality, as reflected by clinical scores, laboratory parameters and intensive care interventions. Furthermore, our data indicates that demographic factors like age do not affect the outcome of allo-HSCT.
CONCLUSION: Our study shows that this specific engraftment cohort does not demonstrate different survival rates compared to patients in the early and post-engraftment phases. However, organ failure and sepsis remain significant contributors to the high mortality rates observed in the ICU.