Predicting Survival and Death in Pediatric Hematopoietic Stem Cell Transplant Patients

Strategic Insights -

Children who require intensive care after undergoing hematopoietic stem cell transplant (HSCT) face a high risk of mortality, according to a study published in Hematological Oncology. Researchers analyzed the outcomes of 125 pediatric HSCT recipients and identified several prognostic factors that predict survival and death. The study found that patients who required ICU admission earlier after HSCT, had a longer delay before ICU admission, lacked neutrophil or platelet engraftment, or experienced macroscopic hemorrhage were at higher risk of mortality.

Key Takeaways:

  • The study identified 19 patients (median age 7.8 years, 14 boys) who required 24 ICU admissions post-HSCT, with a survival rate on discharge from ICU of 54%.
  • In univariate analysis, risk factors of mortality included earlier requirement of ICU admission post-HSCT (median 34 versus 166 days, p=.002), a longer delay before ICU admission (median 12 versus 5 hours, p=.02), lack of neutrophil (p=.011) or platelet engraftment (p=.008), and macroscopic hemorrhage (p<0.01).
  • In multivariate analysis, macroscopic hemorrhage and mechanical ventilation remained significant in multivariate analysis.
  • Both PRISM and O-PRISM scores were significant composite prognosticators.
  • Patients with poor prognosticators, such as earlier ICU admission, longer delay before ICU admission, and lack of engraftment, had higher mortality rates.

Statistics:

  • 125 pediatric HSCT recipients were analyzed in the study.
  • 19 patients (15.2%) required ICU admission post-HSCT.
  • The survival rate on discharge from ICU was 54% (10 out of 19 patients).
  • Patients who required earlier ICU admission post-HSCT had a median day of 34 vs. 166 days (p=.002).
  • Patients who had a longer delay before ICU admission had a median of 12 vs. 5 hours (p=.02).
  • The study identified a total of 24 ICU admissions post-HSCT.

Sources:

  • Cheuk, D.K.L., et al. (2004). Prognostic factors in children requiring admission to an intensive care unit after hematopoietic stem cell transplant. Hematol Oncol, 22(1), 1-9.
  • NewsRx.com & NewsRx.net. (2004). Indicators predict survival/death in pediatric hematopoietic stem cell transplant patients admitted to an intensive care unit. Health & Medicine Week, 12(31), 1-2.