Death causes analysis of 35 patients after allogeneic hematopoietic stem cell transplantation / 重庆医学

ABSTRACT

Objective To analysis the different causes of death among patients who underwent allogeneic hematopoietic stem cell transplantation in order to explore the disadvantageous factors which affecting the long‐term survival after transplantation . Methods The planned conditioning regimen we used was BU/Cy and associated with mobilized peripheral blood and/or bone mar‐row stem cell .Meanwhile ,we used infection prevention and GVHD control methods .Throughout the treatment we observed the death patients during the allogeneic hematopoietic stem cell transplan‐tation and posttransplant ,however ,the causes of death were retrospectively analyzed .Results Among the 35 death cases ,the reason for 11 patients were relapse ,15 with serious infection (9 cases combine GVHD ,Ⅰ - Ⅱ GVHD 3 cases ,Ⅲ - Ⅳ GVHD 6 cases) ,2 patients underwent hematopoietic failure ,2 patients died of intracranial hemorrhage ,1 patient had pulmonary edema ,1 patient sudden death ,1 patient suffered from intestinal tract because of serious GVHD ,1 patient had a progression of disease ,and 1 hemolytic crisis .With a 100 days transplantation related mortality (TRM ) was 5 .7% ,and transplantation within 100 days to 1 year of TRM was 8 .1% .We received a 3‐year and 5‐year mortality rates of 16 .2% and 16 .7% ,respectively .Conclusion Infection ,GV HD and disease relapse are the most common causes of death a‐mong patients who underwent hematopoietic stem cell transplantation .Deadly infection is commonly observed within one year after transplantation and with which accompanied by the GVHD usually .Patients associated with cGVHD have a lower rate of disease re‐lapse .